Complications and mortality after catheter ablation of ventricular arrhythmias: risk in VT ablation (RIVA) score

Shibu Mathew*, Thomas Fink*, Sebastian Feickert, Osamu Inaba, Naotaka Hashiguchi, Michael Schlüter, Peter Wohlmuth, Erik Wissner, Roland Richard Tilz, Christian Hendrik Heeger, Laura Rottner, Bruno Reissmann, Andreas Rillig, Andreas Metzner, Tilman Maurer, Karl Heinz Kuck, Feifan Ouyang*

*Corresponding author for this work
13 Citations (Scopus)

Abstract

Aims: Catheter ablation of ventricular arrhythmias (VA) has proven to be an effective therapeutic option for secondary arrhythmia prophylaxis. We sought to assess the procedural efficacy, safety and in-hospital mortality of a large patient cohort with and without structural heart disease undergoing VA ablation. Methods: A total of 1417 patients (804 patients with structural heart disease) undergoing 1792 endo- and epicardial procedures were analyzed. Multivariable risk factor analysis for occurrence of major complications and intrahospital mortality was obtained and a score to allow preprocedural risk assessment for patients undergoing VA ablation procedures was established. Results: Major complication occurred in 4.4% of all procedures and significantly more often in patients with structural heart disease than in structurally normal hearts (6.0 vs. 1.8%). The frequency of these periprocedural complications was significantly different between procedures with sole right ventricular and a combination of RV and LV access (0.5 vs. 3.1%). The most common complication was cardiac tamponade in 46 cases (3.0%). Intrahospital death was observed in 32 patients (1.8%). Logistic regression model revealed presence of ischemic heart disease, epicardial ablation, presence of oral anticoagulation or dual antiplatelet therapy as independent risk factors for the occurrence of complications or intrahospital death, while a history of previous heart surgery was an independent predictor with a decreased risk. Based on this analysis a risk score incorporating 5 standard variables was established to predict the occurrence of complications and intrahospital mortality. Conclusions: Safety of VA catheter ablation mainly relies on patient baseline characteristics and the type of access into the ventricles or epicardial space.

Original languageEnglish
JournalClinical Research in Cardiology
Volume111
Issue number5
Pages (from-to)530-540
Number of pages11
ISSN1861-0684
DOIs
Publication statusPublished - 05.2022

Research Areas and Centers

  • Centers: Cardiological Center Luebeck (UHZL)

DFG Research Classification Scheme

  • 205-12 Cardiology, Angiology

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