Catheter Ablation -> Ventricular Arrhythmias -> Quality Measures & Complications D-PO06 - Poster Session VI (ID 26) Poster

D-PO06-118 - Impact Of Antithrombotic Therapy On Procedural Safety Of Catheter Ablation Of Ventricular Arrhythmias (ID 1370)

Abstract

Background: Catheter ablation of ventricular arrhythmias (VA) has proven to be an effective therapy option for secondary arrhythmia prophylaxis. Periprocedural complications include bleeding at vascular or access sites and cardiac tamponade. Patients who undergo VA ablation procedures are often on antiplatelet therapy (APT) and/or oral anticoagulation (OAC) at the timepoint of the procedure.
Objective: To study the impact of antithrombotic therapy on safety if VA ablation.
Methods: Patients undergoing VA ablation from 2002 until 2017 at a German tertiary care hospital were retrospectively analyzed. Multivariable risk factor analysis for the occurrence of complications and intrahospital mortality was obtained. A logistic regression model was applied to relate the covariates that were selected according to medical points of view to the incidence of complications and intrahospital death.
Results: A total of 1792 VA ablation procedures in 1417 patients were analyzed. Structural heart disease was present in 804 patients (56.7%). 271 procedures (19.1%) included epicardial mapping with or without epicardial ablation. A total of 125 patients (8.8%) were on dual antiplatelet therapy, 25 patients (1.7%) were on triple therapy and 444 patients (31.3%) were on OAC at the timepoint of VA ablation.Major complication occurred in 77 procedures (4.4% of all procedures) including 56 cases of cardiac tamponade, 8 cases of groin access site complication with need for surgical repair and 1 peripheral vessel injury. Thirty-two patients (1.8%) suffered from intrahospital death.Logistic regression model revealed presence of dual APT (p=0.0023) and OAC (p=0.0080) as independent factors associated with the occurrence of major complications and intraprocedural death. A statistical trend was found for an association with less frequent complications and intrahospital deaths for the presence of previous heart surgery (p=0.0504).
Conclusion: Presence of dual APT and OAC are independent predictors of major procedural complications and intrahospital mortality in patients undergoing catheter ablation of VA. These findings have impact of preprocedural planning, especially for patients undergoing elective VA ablation procedures.
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