{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T11:09:49Z","timestamp":1773313789336,"version":"3.50.1"},"reference-count":44,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Deutsche Herzstiftung e.V."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Objective and Background: With the increasing use of catheter ablation for tachyarrhythmias, continuous evaluation of in-hospital complications is essential. This study aimed at analyzing complications associated with catheter ablation for atrial fibrillation (AF), atrial flutter (AFL), and ventricular tachycardia (VT) using nationwide administrative data. Methods: We conducted a retrospective multicentric data analysis from large German ablation centers between 2018 and 2023. Patients were identified using ICD and OPS codes for AF, AFL, and VT regarding predefined in-hospital complications: mortality, stroke, pericardial tamponade, pulmonary embolism, and vascular complications requiring intervention. Results: Among 19,258 ablation procedures from 11 centers, AF was most common (n = 12,241), followed by AFL (n = 5582) and VT (n = 1435). Major complications occurred in 2.2% (n = 433) of cases. VT ablations had the highest complication rate (9.8%), followed by AF (1.6%) and AFL (1.7%). Pericardial tamponade occurred in 0.9% patients, most commonly in VT ablations (4.0%). Vascular complications requiring intervention were reported in 1.1%, while stroke (0.3%) and pulmonary embolism (0.05%) were rare. In-hospital mortality was highest in VT patients (2.4%), compared to AF (0.08%) and AFL (0.13%). Higher AFL mortality as compared to AF was associated with older age and more comorbidities. Upon exploratory analysis, no statistical association between hospital volume and complication rates could be seen. Conclusions: In this multicenter analysis, catheter ablation was associated with a low overall complication rate. VT ablations carried the highest risk, highlighting the impact of structural heart disease and comorbidities.<\/jats:p>","DOI":"10.3390\/jcdd13030134","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T16:41:47Z","timestamp":1773247307000},"page":"134","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nationwide Multicentric Analysis Regarding In-Hospital Complications After Catheter Ablation of Cardiac Arrhythmias"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5237-6283","authenticated-orcid":false,"given":"Florian","family":"Doldi","sequence":"first","affiliation":[{"name":"Department for Cardiology II: Electrophysiology, University Hospital M\u00fcnster, Albert-Schweitzer-Campus 1 Geb\u00e4ude A1, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0217-3960","authenticated-orcid":false,"given":"Christian","family":"Meyer","sequence":"additional","affiliation":[{"name":"Departement of Cardiology, Angiology, Intensive Care Medicine, EVK D\u00fcsseldorf, cNEP, cardiac Neuro- and Electrophysiology Research Consortium, 40217 D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9221-9856","authenticated-orcid":false,"given":"Johannes","family":"Brachmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Pulmonology, Klinikum Coburg, 96450 Coburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1400-6254","authenticated-orcid":false,"given":"Fabienne","family":"Kreimer","sequence":"additional","affiliation":[{"name":"Department for Cardiology II: Electrophysiology, University Hospital M\u00fcnster, Albert-Schweitzer-Campus 1 Geb\u00e4ude A1, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten","family":"Lewalter","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Intensive Unit Care, Hospital Munich South, Peter Osypka Heart Center, 81379 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Tilz","sequence":"additional","affiliation":[{"name":"Department of Cardiac Electrophysiology, University Hospital Schleswig-Holstein-Campus L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malte","family":"Kuniss","sequence":"additional","affiliation":[{"name":"Kerckhoff Heart Center, 61231 Bad Nauheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1974-6147","authenticated-orcid":false,"given":"Ibrahim","family":"Akin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, First Department of Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Sommer","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart and Diabetes Center NRW, Ruhr University Bochum, 32545 Bad Oeynhausen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Riemer","sequence":"additional","affiliation":[{"name":"Stiftung Institut f\u00fcr Herzinfarktforschung (IHF), 67063 Ludwigshafen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen","family":"Senges","sequence":"additional","affiliation":[{"name":"Stiftung Institut f\u00fcr Herzinfarktforschung (IHF), 67063 Ludwigshafen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3735-8503","authenticated-orcid":false,"given":"Lars","family":"Eckardt","sequence":"additional","affiliation":[{"name":"Department for Cardiology II: Electrophysiology, University Hospital M\u00fcnster, Albert-Schweitzer-Campus 1 Geb\u00e4ude A1, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1093\/eurheartj\/ehz467","article-title":"2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe 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":"ref_2","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): Developed by the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC), with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Endorsed by the European Stroke Organisation (ESO)","volume":"45","author":"Rienstra","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"euad091","DOI":"10.1093\/europace\/euad091","article-title":"Spotlight on the 2022 ESC guideline management of ventricular arrhythmias and prevention of sudden cardiac death: 10 novel key aspects","volume":"25","author":"Dagres","year":"2023","journal-title":"Europace"},{"key":"ref_4","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 J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.jacep.2017.12.008","article-title":"Early Versus Late Referral for Catheter Ablation of Ventricular Tachycardia in Patients with Structural Heart Disease: A Systematic Review and Meta-Analysis of Clinical Outcomes","volume":"4","author":"Romero","year":"2018","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1111\/j.1540-8167.2011.02081.x","article-title":"Ventricular tachycardia ablation remains treatment of last resort in structural heart disease: Argument for earlier intervention","volume":"22","author":"Frankel","year":"2011","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1007\/s00392-022-02090-3","article-title":"10-year follow-up of interventional electrophysiology: Updated German survey during the COVID-19 pandemic","volume":"112","author":"Eckardt","year":"2022","journal-title":"Clin. Res. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1016\/j.jacep.2017.05.005","article-title":"Catheter Ablation for Cardiac Arrhythmias: Utilization and In-Hospital Complications, 2000 to 2013","volume":"3","author":"Hosseini","year":"2017","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"euad361","DOI":"10.1093\/europace\/euad361","article-title":"Major in-hospital complications after catheter ablation of cardiac arrhythmias: Individual case analysis of 43 031 procedures","volume":"26","author":"Eckardt","year":"2023","journal-title":"Europace"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1161\/CIRCEP.114.001530","article-title":"Complications of catheter ablation of ventricular tachycardia: A single-center experience","volume":"7","author":"Peichl","year":"2014","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"4020","DOI":"10.1093\/eurheartj\/ehy452","article-title":"Incidence of complications related to catheter ablation of atrial fibrillation and atrial flutter: A nationwide in-hospital analysis of administrative data for Germany in 2014","volume":"39","author":"Steinbeck","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2056","DOI":"10.1016\/j.hrthm.2014.07.012","article-title":"Catheter ablation of postinfarction ventricular tachycardia: Ten-year trends in utilization, in-hospital complications, and in-hospital mortality in the United States","volume":"11","author":"Palaniswamy","year":"2014","journal-title":"Heart Rhythm"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e007045","DOI":"10.1161\/JAHA.117.007045","article-title":"Ablation Outcomes and Predictors of Mortality Following Catheter Ablation for Ventricular Tachycardia: Data from the German Multicenter Ablation Registry","volume":"7","author":"Tilz","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1007\/s00392-021-01902-2","article-title":"Complications and mortality after catheter ablation of ventricular arrhythmias: Risk in VT ablation (RIVA) score","volume":"111","author":"Mathew","year":"2022","journal-title":"Clin. Res. Cardiol."},{"key":"ref_15","first-page":"100","article-title":"Catheter ablation of ventricular arrhythmias and in-hospital mortality: Insights from the German-wide Helios hospital network of 5052 cases","volume":"22","author":"Ueberham","year":"2020","journal-title":"Europace"},{"key":"ref_16","first-page":"701","article-title":"Administrative data confirm safety of same-day discharge following catheter ablation of atrial fibrillation: All good or is there a fly in the ointment?","volume":"24","author":"Andrade","year":"2022","journal-title":"EP Eur."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3947","DOI":"10.1093\/eurheartj\/ehy528","article-title":"In-hospital mortality of patients with atrial arrhythmias: Insights from the German-wide Helios hospital network of 161 502 patients and 34 025 arrhythmia-related procedures","volume":"39","author":"Ueberham","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1161\/CIRCULATIONAHA.113.003862","article-title":"In-Hospital Complications Associated with Catheter Ablation of Atrial Fibrillation in the United States Between 2000 and 2010","volume":"128","author":"Deshmukh","year":"2013","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1016\/j.jacc.2023.03.418","article-title":"Procedure-Related Complications of Catheter Ablation for Atrial Fibrillation","volume":"81","author":"Benali","year":"2023","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s10840-022-01357-z","article-title":"Complications of catheter ablation for ventricular tachycardia","volume":"66","author":"Pastapur","year":"2023","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s10840-020-00769-z","article-title":"Efficacy and complications of cavo-tricuspid isthmus-dependent atrial flutter ablation in patients with and without structural heart disease: Results from the German Ablation Registry","volume":"61","author":"Dechering","year":"2021","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1016\/j.hrthm.2011.05.017","article-title":"Incidence and predictors of major complications from contemporary catheter ablation to treat cardiac arrhythmias","volume":"8","author":"Bohnen","year":"2011","journal-title":"Heart Rhythm"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1161\/CIRCEP.109.871665","article-title":"Long-term outcomes after catheter ablation of cavo-tricuspid isthmus dependent atrial flutter: A meta-analysis","volume":"2","author":"Perez","year":"2009","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1007\/s00392-023-02223-2","article-title":"Predictors for major in-hospital complications after catheter ablation of ventricular arrhythmias: Validation and modification of the Risk in Ventricular Ablation (RIVA) Score","volume":"112","author":"Doldi","year":"2023","journal-title":"Clin. Res. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s10840-021-00948-6","article-title":"Complication rates following ventricular tachycardia ablation in ischaemic and non-ischaemic cardiomyopathies: A systematic review","volume":"63","author":"Ding","year":"2022","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1111\/jce.13042","article-title":"Vascular Complications During Catheter Ablation of Cardiac Arrhythmias: A Comparison Between Vascular Ultrasound Guided Access and Conventional Vascular Access","volume":"27","author":"Sharma","year":"2016","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1001\/jama.2019.0693","article-title":"Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients with Atrial Fibrillation: The CABANA Randomized Clinical Trial","volume":"321","author":"Packer","year":"2019","journal-title":"JAMA"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1056\/NEJMoa2029980","article-title":"Cryoablation or Drug Therapy for Initial Treatment of Atrial Fibrillation","volume":"384","author":"Andrade","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1056\/NEJMoa2029554","article-title":"Cryoballoon Ablation as Initial Therapy for Atrial Fibrillation","volume":"384","author":"Wazni","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1056\/NEJMoa2307291","article-title":"Pulsed Field or Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation","volume":"389","author":"Reddy","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"euad185","DOI":"10.1093\/europace\/euad185","article-title":"EUropean real-world outcomes with Pulsed field ablatiOn in patients with symptomatic atRIAl fibrillation: Lessons from the multi-centre EU-PORIA registry","volume":"25","author":"Schmidt","year":"2023","journal-title":"Europace"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1093\/europace\/euab065","article-title":"2021 European Heart Rhythm Association Practical Guide on the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation","volume":"23","author":"Steffel","year":"2021","journal-title":"Europace"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1253\/circj.CJ-21-0162","article-title":"JCS\/JHRS 2021 Guideline Focused Update on Non-Pharmacotherapy of Cardiac Arrhythmias","volume":"86","author":"Nogami","year":"2022","journal-title":"Circ. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Joglar","year":"2024","journal-title":"Circulation"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/europace\/eux274","article-title":"2017 HRS\/EHRA\/ECAS\/APHRS\/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation","volume":"20","author":"Calkins","year":"2018","journal-title":"Europace"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1093\/europace\/euab175","article-title":"Meta-analysis of controlled studies on minimally interrupted vs. continuous use of non-vitamin K antagonist oral anticoagulants in catheter ablation for atrial fibrillation","volume":"23","author":"Westra","year":"2021","journal-title":"Europace"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.chest.2017.05.040","article-title":"Venous Thrombosis After Electrophysiology Procedures: A Systematic Review","volume":"152","author":"Burstein","year":"2017","journal-title":"Chest"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s10840-018-0461-9","article-title":"Prevention of venous thrombosis after electrophysiology procedures: A survey of national practice","volume":"53","author":"Burstein","year":"2018","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2657","DOI":"10.1056\/NEJMoa065457","article-title":"Prophylactic catheter ablation for the prevention of defibrillator therapy","volume":"357","author":"Reddy","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1055\/s-0044-1785519","article-title":"In-Hospital Pulmonary Arterial Embolism after Catheter Ablation of Over 45,000 Cardiac Arrhythmias: Individualized Case Analysis of Multicentric Data","volume":"124","author":"Doldi","year":"2024","journal-title":"Thromb. Haemost."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"euad364","DOI":"10.1093\/europace\/euad364","article-title":"Prevention of venous thromboembolism in right heart-sided electrophysiological procedures: Results of an European Heart Rhythm Association survey","volume":"26","author":"Mugnai","year":"2023","journal-title":"Europace"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1007\/s00392-024-02378-6","article-title":"Epicardial ventricular tachycardia ablation: Safety and efficacy of access and ablation using low-iodine content","volume":"114","author":"Chakarov","year":"2025","journal-title":"Clin. Res. Cardiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.4022\/jafib.2077","article-title":"Current Safety of Pulmonary Vein Isolation in Paroxysmal Atrial Fibrillation: First Experience of Same Day Discharge","volume":"11","author":"Ignacio","year":"2018","journal-title":"J. Atr. Fibrillation"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1016\/j.jacep.2023.04.014","article-title":"Performance of the REAL-AF Same-Day Discharge Protocol in Patients Undergoing Catheter Ablation of Atrial Fibrillation","volume":"9","author":"Rajendra","year":"2023","journal-title":"JACC Clin. Electrophysiol."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/3\/134\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T16:46:35Z","timestamp":1773247595000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/3\/134"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,11]]},"references-count":44,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcdd13030134"],"URL":"https:\/\/doi.org\/10.3390\/jcdd13030134","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,11]]}}}