Patient characteristics, procedure details including catheter devices, and complications of catheter ablation for ventricular tachycardia: a nationwide observational study

BACKGROUND: Nationwide data are insufficient with respect to the characteristics of patients undergoing ventricular tachycardia (VT) ablation, complications of VT ablation, and procedure details including catheter devices used during VT ablation. The present study was performed to describe the patient characteristics, procedure details including catheter devices, and in-hospital complications of catheter ablation for VT using a national inpatient database. METHODS: We used the Diagnosis Procedure Combination database, a national Japanese inpatient database, to identify patients who underwent VT ablation from July 2010 to March 2017. We examined patients' age, gender, baseline diseases, comorbid conditions, admission status, catheter devices and drugs used, and in-hospital complications of VT ablation. RESULTS: We identified 10 641 patients (median age, 61 years) who underwent VT ablation. The most frequently observed background heart disease among patients with structural heart disease was ischemic cardiomyopathy. An irrigated ablation catheter was used in 73% of patients, a force-sensing ablation catheter was used in 22%, and intracardiac echocardiography was used in 25%. The frequency of using these procedures continuously increased over time. Overall, the prevalence of in-hospital complications was 3.5% (cardiac tamponade, 0.8%; stroke, 0.6%; critical bleeding, 1.9%; mechanical circulatory support, 0.9%; and in-hospital death, 0.8%). CONCLUSIONS: The results of this study show the clinical features of VT ablation in a real-world clinical setting. The use of irrigated catheters, force-sensing catheters, and intracardiac echocardiography increased over time. The prevalence of in-hospital complications was 3.5%.