Abstract 18697: Utilization of Atrial Flutter Ablation and its Complications - Analysis of 38000 Procedures

Abstract

Introduction: Radiofrequency ablation (RFA) of atrial flutter (AFL) is considered as a reasonable approach due to its effectiveness, feasibility and safety. Data regarding the utilization and safety of RFA for AFL outside of selected centers of excellence and in older patients are limited. Methods: Using the Nationwide Inpatient Sample (NIS) between the years 2000-2008, we developed a coding algorithm to identify AFL patients treated with ablations. We investigated common complications like cardiac perforation and/or tamponade, pneumothorax, stroke, transient ischemic attack (TIA), vascular access complication (consisting of hemorrhage/hematoma, vascular complication requiring surgical repair, and accidental puncture), and in-hospital death described with AFL ablation and defined them by validated International Classification of Diseases (9th Edition) Clinical Modification (ICD-9-CM) diagnosis codes. Results: There were a total of 38,881 AFL ablations performed from the years 2000 to 2008. Majority of ablations were performed in patients with age > 65 years, men, white race, less severe comorbidities, large bed size and teaching hospitals. The overall inhospital mortality was 15/1000. The overall complication rate was 0.3%. On multivariate analysis, apart from male gender, patient and hospital characteristics were not associated with increased complications. The length of stay and total charges were 1.5 and 2.5 times more in hospitalizations associated with complications. Conclusions: AFL ablation is safe with perforation/tamponade and vascular access complications accounting for the majority