Key result
Catheter ablation achieves high acute success for most arrhythmias with a ~3% overall complication rate.
Why the study?
Real-world data on the type of ablation procedures, acute outcomes, and complications related to catheter ablation in Japan were lacking for 2018.
What are the acute outcomes and complication rates of catheter ablation for various arrhythmias in a real-world nationwide registry?
Observational (n=55,525)
Yes
What are the acute outcomes and complication rates of catheter ablation for various arrhythmias in a real-world nationwide registry?
The nationwide J-AB registry demonstrates that catheter ablation in Japan has a high acute success rate (>90%) and a low overall acute complication rate (2.8%) across various arrhythmias.
Japanese ablation registry data may benchmark real-world outcomes; leaves open prospective validation of safety and generalizability.
Background To analyze the type of ablation procedure, acute outcomes, and complications related to catheter ablation in Japan during the year of 2018. Method The Japanese Catheter Ablation (J‐AB) registry is a voluntary, nationwide, multicenter, prospective, observational registry, performed by the Japanese Heart Rhythm Society (JHRS) in collaboration with the National Cerebral and Cardiovascular Center using a Research Electronic Data Capture system. The procedural outcome and complications during hospitalizations were collected. Result A total of 55 525 procedures (mean age of 64.5 years and 66.5% male) from 369 hospitals were collected. The total number of target arrhythmias was 61 610 including atrial fibrillation (AF, 65.6%), atrial flutter (AFL) or atrial tachycardia (16.7%), atrioventricular nodal reentrant tachycardia (7.4%), atrioventricular reentrant tachycardia (3.5%), premature ventricular contractions (4.1%), and ventricular tachycardia (VT, 2.0%). Over a 90% acute success rate was observed among all arrhythmias except for VT due to structural heart disease, and notably, an over 99% success rate was achieved for pulmonary vein isolation of AF and inferior vena cava‐tricuspid valve isthmus block for isthmus‐dependent AFL. Acute complications during hospitalization were observed in 1558 patients (2.8%), including major bleeding (Bleeding Academic Research Consortium: BARC criteria ≥2) in 1.1%, cerebral or systemic embolisms in 0.2%, and death in 0.1%. Acute complications were more often observed with AF ablation (P < .001), especially the first AF ablation session and with structural heart disease (P < .001). Conclusion The J‐AB registry provided real‐world data regarding the acute outcomes and complications of ablation for the various types of arrhythmias in Japan.
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Kusano et al. (2020) conducted an observational in Arrhythmias (n=55,525). Catheter ablation was evaluated on Acute complications during hospitalization. In a nationwide Japanese registry of 55,525 catheter ablation procedures, acute success exceeded 90% for most arrhythmias, with an overall acute complication rate of 2.8%.
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