Complications of catheter-based electrophysiology procedures in adults with congenital heart disease: A national analysis

Bryan G. Maxwell, Jochen Steppan, Alan Cheng

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Abstract

Objective To determine whether adult congenital heart disease patients (ACHD) undergoing catheter-based electrophysiology (EP) procedures have an increased risk for complications compared with adults without congenital heart disease. Design Retrospective cohort study of a national administrative database. Setting Nationwide Inpatient Sample, 1998 through 2011. Participants All admission records of patients who underwent a catheter-based electrophysiology procedure, categorized based on the presence or absence of ACHD. Interventions ACHD and non-ACHD cohorts were compared with respect to baseline, procedural, and outcome characteristics. Measurements and Main Results ACHD patients accounted for n = 15,133 (1.7%) of n = 873,437 EP procedure admissions and comprised a significantly increasing proportion over the study period (from 0.8% in 1998 to 2.4% in 2011, p<0.0001). ACHD patients were younger than non-ACHD patients (52.5±0.3 years v 61.9±0.04 years; p<0.0001), had a longer length of stay (4.6±0.1 days v 4.4±0.01 days, p = 0.013), higher total hospital charges ($89,485±$1,543 v $70,456±$175, p<0.0001), and a higher rate of procedure-related complications (odds ratio 1.66, 95% confidence interval 1.49-1.85, p<0.0001). On multivariate analysis, ACHD patients continued to demonstrate an increased risk of procedural complications (odds ratio 1.95, 95% confidence interval 1.75-2.19, p<0.0001). Conclusions ACHD patients experienced greater morbidity after catheter-based EP procedures. This finding will be of increasing significance as ACHD patients occupy a growing segment of the population undergoing these procedures. Further investigations are warranted to determine whether this increased risk is modifiable, with the aim of improving patient safety.

Original languageEnglish (US)
Pages (from-to)258-264
Number of pages7
JournalJournal of cardiothoracic and vascular anesthesia
Volume29
Issue number2
DOIs
StatePublished - Apr 1 2015

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Keywords

  • ablations
  • adult congenital heart disease
  • catheter-based procedures
  • electrophysiology
  • procedural complications

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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