Interventional electrophysiology in Bulgaria in 2023: data from the electronic registry BG-EPHY

This study presents data from the national electronic registry BG-EPHY on electrophysiologic (EP) cardiac ablations in 2023. Material and methods. This is a retrospective study of a full one-year sample of the BG-EPHY registry. Sex and age distribution of the patients, number of ablations, use of electroanatomic mapping (EAM), irrigated and cryoablations, distribution of different types of arrhythmias, acute procedural success, and complications are presented. Results. In 2023 nine EP centers performed 2021 ablations in 1309 men (61.8%) and 807 women, incl. 20 ablations in pediatric patients (1%). EAM was used in 941 procedures (46.6%), irrigated-tip catheter – in 1121 (55.5%), cryocatheter – in 420 (20.8%), and intracardiac echocardiography – in 43 (2.1%). The most frequently performed ablation was pulmonary vein isolation (46.4%), followed by ablation for AV nodal reentrant tachycardia (16.3%) and typical atrial flutter (15.2%). The acute success was over 98%, while intraprocedural complications were less than 2%. Conclusion. The national registry of electrophysiology collects systematically and continuously basic data on all ablations of cardiac arrhythmias performed in  the country. In 2023, after the end of the COVID-19 pandemic, the number of ablations increased compared to 2022, but at a slightly slower rate. Distribution of EP procedure types was similar to previous years. Acute success was very high, while intraprocedural complications were rare.