Impact of age on hospital outcomes after catheter ablation for ventricular tachycardia

Mingliang Tan, Y. H. Yeo, Q. Ang, Chrystina Kiwan, O. Fatunde, Justin Z. Lee, Aneesh Tolat, D. Sorajja
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Abstract

The 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.Using 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.Our 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).Elderly 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.
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年龄对室性心动过速导管消融术后住院效果的影响
有关老年患者室性心动过速(VT)消融安全性的实际数据尚不完善。本研究旨在评估接受室速导管消融术的 18-64 岁患者与≥65 岁患者的手术结果。我们的研究使用了全国再入院数据库,纳入了在 2017 年至 2020 年期间接受室速导管消融术的年龄≥18 岁的患者。我们将患者分为非老年组(18-64 岁)和老年组(≥65 岁)。我们的研究纳入了 2075 名(49.1%)接受 VT 消融术的非老年患者和 2153 名(50.9%)老年患者。术后,老年患者的指数住院时间延长率(≥7 天;35.5% vs. 29.3%,P < .01)、非居家出院率(13.4% vs. 6.0%,P < .01)、30 天再入院率(17.0% vs. 11.4%,P < .01)和早期死亡率(5.5% vs. 2.4%,P < .01)均显著高于非老年患者。两组患者的手术并发症,即血管并发症、血心包积液/心脏填塞、脑血管意外(CVA)、需要输血的大出血和全身栓塞没有明显差异。通过多变量分析,老年组与较高的早期死亡率(OR:7.50;CI:1.86-30.31,P = .01)、非家庭出院(OR:2.41;CI:1.93-3.00,P < .01)和 30 天再入院(OR:1.58;CI:1.32-1.89,P < .01)相关。老年组和非老年组在手术并发症方面无明显差异。
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