Department for Cardiology II: Electrophysiology, University Hospital Münster, Albert-Schweitzer-Campus 1 Gebäude A1, D-48149 Münster, Germany.
Department of Cardiology and Intensive Care, Asklepios Clinic St. Georg, Hamburg, Germany.
Europace. 2023 Feb 8;25(1):130-136. doi: 10.1093/europace/euac146.
The incidence of in-hospital post-interventional complications and mortality after ablation of supraventricular tachycardia (SVT) vary among the type of procedure and most likely the experience of the centre. As ablation therapy of SVT is progressively being established as first-line therapy, further assessment of post-procedural complication rates is crucial for health care quality.
We aimed at determining the incidence of in-hospital mortality and bleeding complications from SVT ablations in German high-volume electrophysiological centres between 2005 and 2020. All cases were registered by the German Diagnosis Related Groups-and the German Operation and Procedure Classification (OPS) system. A uniform search for SVT ablations from 2005 to 2020 with the same OPS codes defining the type of ablation/arrhythmia as well as the presence of a vascular complication, cardiac tamponade, and/or in-hospital death was performed. An overall of 47 610 ablations with 10 037 SVT ablations were registered from 2005 to 2020 among three high-volume centres. An overall complication rate of 0.5% (n = 38) was found [median age, 64; ±15 years; female n = 26 (68%)]. All-cause mortality was 0.02% (n = 2) and both patients had major prior co-morbidities precipitating a lethal outcome irrespective of the ablation procedure. Vascular complications occurred in 10 patients (0.1%), and cardiac tamponade was detected in 26 cases (0.3%).
The present case-based analysis shows an overall low incidence of in-hospital complications after SVT ablation highlighting the overall very good safety profile of SVT ablations in high-volume centres. Further prospective analysis is still warranted to guarantee continuous quality control and optimal patient care.
经导管消融术治疗室上性心动过速(SVT)后院内介入相关并发症和死亡率因手术类型而有所不同,且可能与中心经验相关。由于 SVT 的消融治疗正逐渐成为一线治疗方法,因此进一步评估术后并发症发生率对于医疗质量至关重要。
我们旨在确定 2005 年至 2020 年间德国大容量电生理中心行 SVT 消融术的院内死亡率和出血并发症发生率。所有病例均通过德国诊断相关组(Diagnosis Related Groups, DRG)和德国手术和操作分类(Operation and Procedure Classification, OPS)系统进行登记。我们采用统一的搜索方法,从 2005 年至 2020 年搜索使用相同 OPS 编码的 SVT 消融术,这些 OPS 编码定义了消融/心律失常的类型,以及是否存在血管并发症、心脏压塞和/或院内死亡。2005 年至 2020 年,三家大容量中心共登记了 47610 例消融术,其中 10037 例为 SVT 消融术。总体并发症发生率为 0.5%(n=38)[中位年龄 64±15 岁;女性 26 例(68%)]。总死亡率为 0.02%(n=2),两名患者均存在严重的合并症,导致致命后果,与消融术无关。10 例患者发生血管并发症(0.1%),26 例患者发生心脏压塞(0.3%)。
本病例分析显示,SVT 消融术后院内并发症的总体发生率较低,突出了大容量中心行 SVT 消融术的整体安全性非常好。仍需进一步前瞻性分析以保证持续的质量控制和最佳的患者护理。