National Study Finds Fewer Complications from Cardiac Ablation Procedure at High-Volume Facilities

Atrial flutter (AFL) ablation therapy is a growing front-line treatment for patients with certain types of irregular heartbeats or arrhythmias. However, a national study of nearly 90,000 procedures found that high-volume facilities have a lower rate of complications, according to Juan Viles-Gonzalez, M.D., assistant professor of cardiology at the University of Miami Miller School of Medicine.

“While AFL ablation has been safely performed over the past decades, this study underscores the importance of physician and facility experience for better patient safety and outcomes,” said Viles-Gonzalez. “A multidisciplinary approach involving electrophysiologists, nurses and technicians, in an environment with appropriate training of the supporting staff for management of complications associated with ablation, also appears to be important.”

Viles-Gonzalez was lead author of the study, “Contemporary Utilization and Safety Outcomes of Catheter Ablation of Atrial Flutter in the United States: Analysis of 89,638 Procedures,” published recently in Heart Rhythm Journal, a leading publication in cardiac electrophysiology.

The multicenter study analyzed AFL ablation patients from 2000 to 2011 using information from the Nationwide Inpatient Sample, the largest all-payer inpatient data set in the United States. The overall complication rate was 3.17 percent in patients undergoing AFL ablation, including cardiac perforation, pulmonary problems, vascular issues and in-hospital deaths.

“An annual hospital volume of more than 100 procedures per year was associated with a significantly fewer number of complications than in hospitals that performed less than 50 per year,” Viles-Gonzalez said.

About 200,000 cases of AFL are diagnosed each year in the U.S. With proper treatment, the irregular heartbeat can be corrected with little risk of long-term problems.

Viles-Gonzalez said the annual number of AFL ablation procedures tripled during the study period from about 3,600 in 2000 to 9,200 in 2011. The number of hospitals performing these procedures also increased significantly, from 110 to 189 during the decade.

“We also found that the AFL ablation complication rate increased from 2.68 percent to 5.39 percent during the same time frame, possibly because more procedures were done in hospitals with little experience in ablation therapy,” Viles-Gonzalez said. “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.”

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