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Nationwide Multicentric Analysis Regarding In-Hospital Complications After Catheter Ablation of Cardiac Arrhythmias

Florian Doldi1, Christian Meyer2, Johannes Brachmann3

  • 1Department for Cardiology II: Electrophysiology, University Hospital Münster, Albert-Schweitzer-Campus 1 Gebäude A1, 48149 Münster, Germany.

Journal of Cardiovascular Development and Disease
|March 27, 2026
PubMed

Insights

Catheter ablation for tachyarrhythmias is generally safe, with low overall complications. Ventricular tachycardia ablations carry the highest risk, emphasizing the need to consider patient comorbidities and structural heart disease.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Informatics

Background:

  • Catheter ablation is increasingly used for tachyarrhythmias.
  • Continuous evaluation of in-hospital complications is crucial for patient safety.

Purpose of the Study:

  • To analyze in-hospital complications of catheter ablation for atrial fibrillation (AF), atrial flutter (AFL), and ventricular tachycardia (VT).
  • To utilize nationwide administrative data for comprehensive complication assessment.

Main Methods:

  • Retrospective analysis of data from 11 large German ablation centers (2018-2023).
  • Identification of patients using ICD and OPS codes for AF, AFL, and VT.
  • Inclusion of predefined complications: mortality, stroke, pericardial tamponade, pulmonary embolism, and vascular complications requiring intervention.

Main Results:

  • 19,258 ablation procedures were analyzed; AF was most common (n=12,241).
  • Overall major complication rate was 2.2%.
  • Ventricular tachycardia (VT) ablations had the highest complication rate (9.8%) and mortality (2.4%). Pericardial tamponade was most frequent in VT (4.0%).
  • Stroke (0.3%) and pulmonary embolism (0.05%) were rare. No association between hospital volume and complication rates was observed.

Conclusions:

  • Catheter ablation demonstrates a low overall complication rate across AF, AFL, and VT procedures.
  • VT ablations present a significantly higher risk profile, influenced by underlying structural heart disease and comorbidities.
  • Risk stratification and careful patient selection are essential for optimizing outcomes in VT ablation.
Abstract

Keywords:
atrial fibrillationatrial fluttercatheter ablationcomplicationsinterventional electrophysiologymulticentric analysisventricular tachycardia

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