{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:39:43Z","timestamp":1791319183897,"version":"4.3.1"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>In-hospital complications of catheter ablation for atrial fibrillation (AF), atrial flutter (AFL), and ventricular tachycardia (VT) may be overestimated by analyses of administrative data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We determined the incidences of in-hospital mortality, major bleeding, and stroke around AF, AFL, and VT ablations in four German tertiary centres between 2005 and 2020. All cases were coded by the G-DRG- and OPS-systems. Uniform code search terms were applied defining both the types of ablations for AF, AFL, and VT and the occurrence of major adverse events including femoral vascular complications, iatrogenic tamponade, stroke, and in-hospital death. Importantly, all complications were individually reviewed based on patient-level source records. Overall, 43 031 ablations were analysed (30 361 AF; 9364 AFL; 3306 VT). The number of ablations\/year more than doubled from 2005 (n = 1569) to 2020 (n = 3317) with 3 times and 2.5 times more AF and VT ablations in 2020 (n = 2404 and n = 301, respectively) as compared to 2005 (n = 817 and n = 120, respectively), but a rather stable number of AFL ablations (n = 554 vs. n = 612). Major peri-procedural complications occurred in 594 (1.4%) patients. Complication rates were 1.1% (n = 325) for AF, 1.0% (n = 95) for AFL, and 5.3% (n = 175) for VT. With an increase in complex AF\/VT procedures, the overall complication rate significantly increased (0.76% in 2005 vs. 1.81% in 2020; P = 0.004); but remained low over time. Following patient-adjudication, all in-hospital cardiac tamponades (0.7%) and strokes (0.2%) were related to ablation. Major femoral vascular complications requiring surgical intervention occurred in 0.4% of all patients. The in-hospital mortality rate adjudicated to be ablation-related was lower than the coded mortality rate: AF: 0.03% vs. 0.04%; AFL: 0.04% vs. 0.14%; VT: 0.42% vs. 1.48%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Major adverse events are low and comparable after catheter ablation for AFL and AF (\u223c1.0%), whereas they are five times higher for VT ablations. In the presence of an increase in complex ablation procedures, a moderate but significant increase in overall complications from 2005\u201320 was observed. Individual case analysis demonstrated a lower than coded ablation-related in-hospital mortality. This highlights the importance of individual case adjudication when analysing administrative data.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euad361","type":"journal-article","created":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T04:07:32Z","timestamp":1702699652000},"source":"Crossref","is-referenced-by-count":57,"title":["Major in-hospital complications after catheter ablation of cardiac arrhythmias: individual case analysis of 43 031 procedures"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3735-8503","authenticated-orcid":false,"given":"Lars","family":"Eckardt","sequence":"first","affiliation":[{"name":"Department for Cardiology II: Electrophysiology, University Hospital M\u00fcnster , Albert-Schweitzer -Campus 1, 48149 M\u00fcnster , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5237-6283","authenticated-orcid":false,"given":"Florian","family":"Doldi","sequence":"additional","affiliation":[{"name":"Department for Cardiology II: Electrophysiology, University Hospital M\u00fcnster , Albert-Schweitzer -Campus 1, 48149 M\u00fcnster , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9738-4685","authenticated-orcid":false,"given":"Omar","family":"Anwar","sequence":"additional","affiliation":[{"name":"Asklepios Hospital St.Georg, Department of Cardiology and Internal Intensive Care Medicine, Faculty of Medicine, Semmelweis University Campus Hamburg , Hamburg , Germany"},{"name":"DZHK (German Center for Cardiovascular Research), partner site Hamburg\/Kiel\/L\u00fcbeck , Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5626-7749","authenticated-orcid":false,"given":"Nele","family":"Gessler","sequence":"additional","affiliation":[{"name":"Asklepios Hospital St.Georg, Department of Cardiology and Internal Intensive Care Medicine, Faculty of Medicine, Semmelweis University Campus Hamburg , Hamburg , Germany"},{"name":"DZHK (German Center for Cardiovascular Research), partner site Hamburg\/Kiel\/L\u00fcbeck , Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3237-140X","authenticated-orcid":false,"given":"Katharina","family":"Scherschel","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kardiologie, Angiologie, Intensivmedizin, cNEP Research Consortium EVK , D\u00fcsseldorf , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9163-6693","authenticated-orcid":false,"given":"Ann-Kathrin","family":"Kahle","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kardiologie, Angiologie, Intensivmedizin, cNEP Research Consortium EVK , D\u00fcsseldorf , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9453-3016","authenticated-orcid":false,"given":"Aenne S","family":"von Falkenhausen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital, LMU Munich , Munich , Germany"},{"name":"German Center for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1765-871X","authenticated-orcid":false,"given":"Raffael","family":"Thaler","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital, LMU Munich , Munich , Germany"},{"name":"German Center for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Wolfes","sequence":"additional","affiliation":[{"name":"Department for Cardiology II: Electrophysiology, University Hospital M\u00fcnster , Albert-Schweitzer -Campus 1, 48149 M\u00fcnster , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6818-6396","authenticated-orcid":false,"given":"Andreas","family":"Metzner","sequence":"additional","affiliation":[{"name":"DZHK (German Center for Cardiovascular Research), partner site Hamburg\/Kiel\/L\u00fcbeck , Berlin , Germany"},{"name":"Klinik und Poliklinik f\u00fcr Kardiologie, Universit\u00e4res Herz- und Gef\u00e4\u00dfzentrum UKE Hamburg , Hamburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0217-3960","authenticated-orcid":false,"given":"Christian","family":"Meyer","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kardiologie, Angiologie, Intensivmedizin, cNEP Research Consortium EVK , D\u00fcsseldorf , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8890-5749","authenticated-orcid":false,"given":"Stephan","family":"Willems","sequence":"additional","affiliation":[{"name":"Asklepios Hospital St.Georg, Department of Cardiology and Internal Intensive Care Medicine, Faculty of Medicine, Semmelweis University Campus Hamburg , Hamburg , Germany"},{"name":"DZHK (German Center for Cardiovascular Research), partner site Hamburg\/Kiel\/L\u00fcbeck , Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5877-352X","authenticated-orcid":false,"given":"Julia","family":"K\u00f6be","sequence":"additional","affiliation":[{"name":"Department for Cardiology II: Electrophysiology, University Hospital M\u00fcnster , Albert-Schweitzer -Campus 1, 48149 M\u00fcnster , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7026-9609","authenticated-orcid":false,"given":"Philipp Sebastian","family":"Lange","sequence":"additional","affiliation":[{"name":"Department for Cardiology II: Electrophysiology, University Hospital M\u00fcnster , Albert-Schweitzer -Campus 1, 48149 M\u00fcnster , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1431-9886","authenticated-orcid":false,"given":"Gerrit","family":"Frommeyer","sequence":"additional","affiliation":[{"name":"Department for Cardiology II: Electrophysiology, University Hospital M\u00fcnster , Albert-Schweitzer -Campus 1, 48149 M\u00fcnster , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2649-3870","authenticated-orcid":false,"given":"Karl-Heinz","family":"Kuck","sequence":"additional","affiliation":[{"name":"Asklepios Hospital St.Georg, Department of Cardiology and Internal Intensive Care Medicine, Faculty of Medicine, Semmelweis University Campus Hamburg , Hamburg , Germany"},{"name":"DZHK (German Center for Cardiovascular Research), partner site Hamburg\/Kiel\/L\u00fcbeck , Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8824-3581","authenticated-orcid":false,"given":"Stefan","family":"K\u00e4\u00e4b","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital, LMU Munich , Munich , Germany"},{"name":"German Center for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Steinbeck","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital, LMU Munich , Munich , Germany"},{"name":"German Center for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6660-796X","authenticated-orcid":false,"given":"Moritz F","family":"Sinner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital, LMU Munich , Munich , Germany"},{"name":"German Center for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"2024013106503796400_euad361-B1","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1093\/eurheartj\/ehz467","article-title":"2019 ESC guidelines for the management of patients with supraventricular tachycardia The task force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC)","volume":"41","author":"Brugada","year":"2020","journal-title":"Eur Heart J"},{"key":"2024013106503796400_euad361-B2","doi-asserted-by":"crossref","first-page":"3997","DOI":"10.1093\/eurheartj\/ehac262","article-title":"2022 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death","volume":"43","author":"Zeppenfeld","year":"2022","journal-title":"Eur Heart 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