OBJECTIVES: Catheter ablation is indicated in patients with irregular or rapid heartbeats due to e.g., ventricular tachycardia, atrial fibrillation, or atrial flutter. The study objective was to investigate the utilization of catheter ablation to treat cardiac arrhythmia in Germany.

METHODS: This retrospective data analysis was based on German hospital data of the Federal Statistical Office of Germany (DESTATIS) and the Institute for the Hospital Remuneration System (InEK) of the years 2005 to 2021. Catheter ablation for the treatment of cardiac arrhythmia was identified by the OPS code 8-835. The analysis included the OPS code frequency per year and the distribution of age, sex, and methods of ablation using the fifth digit of the OPS code.

RESULTS: The number of OPS codes for catheter ablations increased from 24,242 in 2005 to 230,270 in 2021. The number rose from 2005 to 2017 by 15% on average per year and markedly from 2017 to 2018 by 40%. Afterwards, the increase was 11% to 12% per year except for a 1%-increase from 2019 to 2020. Generally, more men than women received ablation treatment with a sex ratio ranging between 1.4:1 and 1.6:1. More than 75% of patients were 55 years or older. The proportion of conventional radiofrequency ablations decreased from 67% in 2005 to 10% in 2021 whereas the proportion of cooled radiofrequency ablations increased from 14% in 2005 to 31% in 2021. Ablation using three-dimensional electro anatomical mapping techniques rose from 12% in 2005 to 25% in 2021. Cryoablation was first performed in 2010 and constituted 12% of performed ablations in 2021.

CONCLUSIONS: The utilization of catheter ablation to treat cardiac arrhythmia has proliferated over the past 17 years in Germany. The sex ratio remained stable. Methods of ablation have evolved and most treatments in 2021 utilized the cooled radiofrequency ablation.