Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, USA.
Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, NJ, USA.
J Interv Card Electrophysiol. 2024 Apr;67(3):513-521. doi: 10.1007/s10840-023-01614-9. Epub 2023 Aug 2.
Patients with ventricular tachycardia (VT) who require VT ablation are at high risk for readmission. This study aimed to identify the causes and outcomes of 30-day readmission after VT ablation and to analyze the predictors of recurrent VT that required rehospitalization.
Using the Nationwide Readmission Database, our study included patients aged ≥ 18 years who underwent VT catheter ablation between 2017 and 2020. Based on the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), we identified the causes of 30-day readmission by organ systems and analyzed their outcomes. Additional analysis was performed to determine the independent predictors of 30-day readmission for recurrent VT.
Of the 4228 patients who underwent VT ablation, 14.2% were readmitted within 30 days of the procedure. The most common cause of readmission was cardiac events (73.6%). Among the cardiac-related readmissions, recurrent VT (47.7%) and congestive heart failure (CHF) (12.9%) were the most common etiologies. Among the readmissions, patients readmitted for CHF had the highest rate of readmission mortality (9.2%). Of the patients readmitted within 30 days of the procedure, 278 patients (6.8%) were readmitted for recurrent VT. Via multivariable analysis, CHF (OR: 1.97; 95% CI: 1.12-3.47; P = 0.02) and non-elective index admissions (OR: 1.63; 95% CI: 1.04-2.55; P = 0.03) were identified as the independent predictors predictive of 30-day readmissions for recurrent VT.
Recurrent VT was the most common cause of readmission after the VT ablation procedure, and CHF and non-elective index admissions were the significant predictors of these early readmissions. Readmission due to CHF had the highest mortality rate during readmission.
需要进行室性心动过速(VT)消融的患者再入院风险较高。本研究旨在确定 VT 消融后 30 天再入院的原因和结果,并分析需要再次住院的复发性 VT 再入院的预测因素。
利用全国再入院数据库,本研究纳入了 2017 年至 2020 年期间接受 VT 导管消融治疗的年龄≥18 岁的患者。根据国际疾病分类,第十次修订版,临床修正(ICD-10-CM),我们按器官系统确定了 30 天再入院的原因,并分析了其结果。此外,还进行了分析以确定复发性 VT 30 天再入院的独立预测因素。
在接受 VT 消融治疗的 4228 例患者中,有 14.2%的患者在术后 30 天内再入院。再入院的最常见原因是心脏事件(73.6%)。在心脏相关的再入院中,复发性 VT(47.7%)和充血性心力衰竭(CHF)(12.9%)是最常见的病因。在再入院的患者中,因 CHF 再入院的患者再入院死亡率最高(9.2%)。在术后 30 天内再入院的患者中,有 278 例(6.8%)因复发性 VT 再次入院。通过多变量分析,CHF(比值比:1.97;95%置信区间:1.12-3.47;P=0.02)和非择期指数入院(比值比:1.63;95%置信区间:1.04-2.55;P=0.03)被确定为复发性 VT 30 天再入院的独立预测因素。
复发性 VT 是 VT 消融术后再入院的最常见原因,CHF 和非择期指数入院是这些早期再入院的重要预测因素。因 CHF 再入院的患者在再入院期间的死亡率最高。