Kiwan, Chrystina

AbstractBackgroundThe real‐world data on the safety profile of ventricular tachycardia (VT) ablation among elderly patients is not well‐established. This study aimed to evaluate the procedural outcomes among those aged 18–64 years versus those aged ≥65 years who underwent catheter ablation of VT.MethodUsing the Nationwide Readmissions Database, our study included patients aged ≥18 years who underwent VT catheter ablation between 2017 and 2020. We divided the patients into non‐elderly (18–64 years old) and elderly age groups (≥65 years old). We then analyzed the in‐hospital procedural outcome and 30‐day readmission between these two groups.ResultsOur study included 2075 (49.1%) non‐elderly patients and 2153 (50.9%) elderly patients who underwent VT ablation. Post‐procedurally, elderly patients had significantly higher rates of prolonged index hospitalization (≥7 days; 35.5% vs. 29.3%, p < .01), non‐home discharge (13.4% vs. 6.0%, p < .01), 30‐day readmission (17.0% vs. 11.4%, p < .01), and early mortality (5.5% vs. 2.4%, p < .01). There was no significant difference in the procedural complications between two groups, namely vascular complications, hemopericardium/cardiac tamponade, cerebrovascular accident (CVA), major bleeding requiring blood transfusion, and systemic embolization. Through multivariable analysis, the elderly group was associated with higher odds of early mortality (OR: 7.50; CI 1.86–30.31, p = .01), non‐home discharge (OR: 2.41; CI: 1.93–3.00, p < .01) and 30‐day readmission (OR: 1.58; CI 1.32–1.89, p < .01).ConclusionElderly patients have worse in‐hospital outcome, early mortality, non‐home discharge, and 30‐day readmission following catheter ablation for VT. There was no significant difference between elderly and non‐elderly groups in the procedural complications.

Background: Catheter ablation for ventricular tachycardia (VT) has been increasingly performed over the past decades. However, the real-world data on the safety profile of this procedure among elderly patients is limited. Objective: This study aimed to evaluate the procedural outcomes and 30-day readmission among those aged 18-64 years versus those aged ≥65 years who underwent catheter ablation of VT. Method: Using the all-payer, nationally representative Nationwide Readmissions Database, our study included patients aged 18 years or older who underwent VT catheter ablation between 2017 and 2020. We divided the patients into non-elderly (18-64 years old) and elderly age groups (≥65 years old). We then analyzed the in-hospital procedural outcome and 30-day readmission between these groups. Results: Our study included 2075 (49.1%) non-elderly patients and 2153 (50.9%) elderly patients who underwent VT ablation. Following the procedure, elderly patients had significantly higher rates of prolonged index hospitalization (≥7 days) (35.5% vs 29.3%, p<0.01), non-home discharge (13.4% vs 6.0%, p<0.01), 30-day readmission (17.0% vs 11.4%, p<0.01), and early mortality (5.5% v 2.4%, p<0.01). The median cumulative cost of hospitalization was significantly higher in the elder groups ($40,230 vs. $37,612, p ≤0.01). There was no significant difference in the procedural complications between the two groups. Through multivariable analysis, the elderly group was associated with significantly higher odds of early mortality (OR: 7.50; CI 1.86 - 30.31, p=0.01), non-home discharge (OR: 2.41; CI: 1.93 - 3.00, p<0.01) and 30-day readmissions (OR: 1.58; CI 1.32 - 1.89, p<0.01). Conclusion: Our study suggests that elderly patients have poorer in-hospital outcome in early mortality, non-home discharge and 30-day readmissions following catheter ablation for VT. There was no significant difference between elderly and non-elderly groups in the procedural complications.