Abstract
The Swiss Ablation Registry provides a national database for electrophysiologic studies and catheter ablations. We analyzed the database to provide an in-depth look at changing trends over the last 20 years. During the study period a total of 78622 catheter ablations (age 61.0 ± 1.2 years; 63.7% male) were performed in 29 centers. The number of ablations increased by approximately ten-fold in 20 years. Ablation for atrial fibrillation (AF) was the main driver behind this increase, with more than hundred-fold (39.7% of all ablations in 2019). Atrioventricular-nodal-reentrant-tachycardia (AVNRT) and accessory pathways, being the main indications for ablation in 2000 (44.1%/25.1%, respectively), made up of only a small proportion (15.2%/3.5%,) respectively in 2019. Fluoroscopy, ablation, and procedure durations were reduced for all ablations over time. The highest repeat ablations were performed for ventricular tachycardia and AF (24.4%/24.3%). The majority of ablations (63.0%) are currently performed in private hospitals and non-university public hospitals whereas university hospitals had dominated (82.4%) at the turn of the century. A pronounced increase in the number of catheter ablations in Switzerland was accompanied by a marked decrease in fluoroscopy, ablation, and procedure durations. We observed a shift toward more complex procedures in older patients with comorbidities.
Highlights
The Swiss National Pacemaker and Ablation Registry was established in 1992 by the Pacemaker Foundation of Switzerland in order to provide a nationwide database for quality assurance
In 2019, 3D mapping systems were used in more than 42% of all AVNRT and right atrial flutter ablations, further explaining the reason of the reduction of fluoroscopy exposures in recent years
In addition to atrial fibrillation (AF) ablations, we have observed a significant increase in the number atrial flutter ablations over the last 20 years
Summary
The Swiss National Pacemaker and Ablation Registry was established in 1992 by the Pacemaker Foundation of Switzerland in order to provide a nationwide database for quality assurance. The Swiss Registry collected data in paper form for each catheter ablation in the country. The scope of the Swiss Registry was extended to include more extensive clinical data, and since 2013, the data have been collected electronically using a dedicated web platform (CH-PACE Web). The Swiss Ablation Registry provides comprehensive information on catheter ablations, focusing on indications, patient-, and procedural characteristics. All Swiss centers performing catheter ablations are obliged to provide their data in this registry. The purpose of this study is to report the catheter ablation statistics in Switzerland and provide an in-depth look at changing trends over the course of the last 20 years
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