Abstract 331 Both CHA<sub>2</sub>DS<sub>2</sub>VASc-Score and age are important and simple predictors for complications following left-atrial ablation procedures

Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02302-4
Both CHA₂DS₂VASc-Score and age are important and simple predictors for complications following left-atrial ablation procedures
J. Obergassel¹, M. Remmel¹, C. Al-Taie¹, S. Taraba², M. Lemoine², L. Rottner¹, J. Rieß¹, M. Nies¹, S. Kany¹, I. My², J. Wenzel¹, B. Reißmann³, F. Ouyang¹, A. Metzner², P. Kirchhof¹, A. Rillig²
¹Klinik für Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg; ²Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg; ³Allgemeine und Interventionelle Kardiologie, Universitäres Herz- und Gefäßzentrum Hamburg, Hamburg;
Background: Catheter ablation (CA) is the most effective rhythm control treatment for atrial fibrillation (AF) and benefits of early rhythm control (ERC) were recently demonstrated to be enhanced in patients with a high comorbidity burden (CHA₂DS₂-VASc ≥ 4). Purpose: To investigate effects of CHA₂DS₂-VASc-Score including and excluding age on typical complications after left-atrial ablation procedures (prolonged stay, ward upgrade, access site complications, pneumonia, pacemaker implantations, cardiac tamponade). Method: Eligible cases of LA ablation procedures for AF were identified in OPS data between 2013 and 2022. Analysis accounted for different versions of the ICD-10-GM and OPS-ICHI catalogues. Comorbidities and occurrences of complications were defined as derived variables on a case-wise analysis including follow-up cases of individual patients from documented ICD-10 and OPS codes. CHA₂DS₂-VASc-score was calculated from derived variables and demographic parameters. Results: 7510 procedures were identified (36% female, mean age 64±11 years, 19% ≥ 75 years old, 18.3% Cryo-ablation, 80.4% radiofrequency-ablation, 1.3% pulsed-field-ablation). Further baseline characteristics will be reported. Any complication, including mild and severe complications, occurred in 137/5377 (2.5%) of procedures in patients with a CHA₂DS₂-VASc < 4 and in 95/2133 (4.5%) procedures in patients with a CHA₂DS₂-VASc ≥ 4 (p < 0.001). When age was excluded from CHA₂DS₂-VASc-score calculation, any complication occurred in 211/7098 (3.0%) of procedures in patients with a CHA₂DS₂-VASc < 4 and in 21/412 (5.1%) procedures in patients with a CHA₂DS₂-VASc ≥ 4 (p < 0.023). However, when using age ≥ 75 as a grouping variable, any complication occurred in 74/1452 (5.1%) of procedures in patients age 75 years and older but only in 158/6058 (2.6%) of procedures in patients below 75 years of age (p<0.001). Results of further regression and random-forest-based classifications will be reported. Conclusion: Patients with a higher comorbidity burden undergoing catheter ablation for atrial fibrillation in the past 10 years had a higher risk for occurrence of any complication during procedures. Age ≥ 75 years was evenly an important predictor for occurrence of any complication. More in-depth analysis will be provided.
https://dgk.org/kongress_programme/ht2023/aV449.html