OBJECTIVES

Among patients with ventricular tachycardia (VT), catheter ablation has been shown to be an effective treatment that reduces implantable cardioverter-defibrillator (ICD/CRT-D) shocks and prevents recurrences. This study examined the characteristics of commercially insured patients undergoing VT ablation in the United States (US) and assessed their VT-related inpatient readmissions in the 12-month post-ablation period.

METHODS

Patients (aged ≥18 years) with a primary diagnosis of VT who underwent ablation in an inpatient or outpatient setting between 2005-2016 were identified using the IBM MarketScan® Commercial Database. The first ablation occurring during the study period was classified as index ablation. Demographic and clinical characteristics (assessed in the 12-month pre-index ablation baseline period) of patients were examined. Cox regression model was used to determine factors associated with VT-related inpatient readmission in the 12-month period post-index ablation.

RESULTS

A total of 5,373 patients met the study criteria. Almost 57% were in the age group 50-64 years, 53% were male, and 38% were in the South region. Majority (65%) of VT ablations occurred in an outpatient setting, increasing from 45% in 2005 to 73% to 2015. In the 12-month post-index ablation period, 8.5% of patients had VT-related inpatient readmission (ischemic VT: 14.71%; non-ischemic VT: 6.96%). Results from regression analysis revealed inpatient setting (vs. outpatient) of index ablation (hazards ratio [HR] 1.54; confidence interval [CI] 1.26-1.88), baseline ICD/CRT-D implantation (HR 2.94; CI 2.25-3.85), heart failure (HR 1.52; CI 1.14-2.03), and ≥2 prior hospitalization (HR 2.03; CI 1.51-2.73) to be associated with a higher risk of post-ablation 12-month VT-related inpatient readmission.

CONCLUSIONS

There is an increasing trend in VT ablation occurring in an outpatient setting. Setting of ablation and comorbidity status were found to influence readmission rate.