Abstract 19671: Contemporary Patterns of Utilization and Safety Outcomes of Catheter Ablation of Atrial Flutter in the United States

Abstract

Introduction: Atrial flutter ablation has been increasingly offered as first line therapy and has been safely performed over the past few decades. However, limited data exists regarding current utilization and trends in adverse outcomes arising from this procedure. The aim of our study was to examine the frequency of adverse events attributable to atrial flutter (AFL) ablation and the influence of hospital volume on safety outcomes. Hypothesis: We hypothesize an association between hospital volume and adverse outcomes. Methods: With the use of the Nationwide Inpatient Sample, we identified 89,638 AFL patients treated with catheter ablation from 2000-2011. We investigated common complications including cardiac perforation and tamponade, pneumothorax, stroke, transient ischemic attack, vascular access complications, and in-hospital death. We defined these complications by using validated International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. Results: The overall frequency of complications was 3.17%, with combined cardiac complications (1.44%) being the most frequent. Cardiac complications were followed by vascular complications (0.78%), respiratory complications (0.88%), and neurological complications (0.05%). The in-hospital mortality was 0.17%. Low hospital volume (<50 procedures) was significantly associated with increased adverse outcomes. In addition, there was a small, insignificant rise in overall complication rates over time. Conclusions: The overall complication rate was 3.17% in patients undergoing AFL ablation. There was a significant association between low hospital volume and increased adverse outcomes. This suggests a need for future research into identifying the safety measures in AFL ablations and instituting appropriate interventions to improve overall AFL ablation outcomes.