Heart Rhythm. 2025 Nov 27:S1547-5271(25)03122-4. doi: 10.1016/j.hrthm.2025.11.042. Online ahead of print.
ABSTRACT
BACKGROUND: Catheter ablation offers improved cardiovascular outcomes and quality of life for patients with atrial fibrillation (AF). However, it is associated with procedural complications. Reported complication rates vary, and limited data exist regarding complication rate trends within institutions.
OBJECTIVE: This study sought to determine the temporal trend of catheter ablation complication rates within a single institution.
METHODS: Patients undergoing left atrial catheter ablation for AF from 2015-2024 were prospectively enrolled. Data including demographics, disease characteristics, procedural details, and 90-day complications were collected. Logistic regression, adjusted for significant covariates, was used to evaluate secular trends.
RESULTS: A total of 2,453 procedures were included. Patients were largely middle-aged (65.8 years), male (67%), white (89.6%), and overweight (BMI 30). 87 procedures (3.55%) were associated with complications, including 34 major complications (1.38%) and 53 minor complications (2.16%). Major complications significantly decreased over time, from 2.03% in 2015-2018 to 0.85% in 2022-2024 (p=0.040). Female patients experienced significantly higher complication rates compared to male patients (4.94% vs 2.86%, p= 0.009), particularly for major complications (2.22% vs 0.97%, p=0.015). The complication rate for pulsed field ablation was 2.26% (5/221) compared to an overall rate of 3.55%, although this was not statistically significant (p=0.439).
CONCLUSION: Major complications from catheter ablation significantly decreased over time. This may be attributed to operator and institutional experience, and incorporation of improved technologies and safety techniques. No statistically significant difference was observed between ablation catheter types, but this may have been limited by sample size and warrants further investigation.
PMID:41317939 | DOI:10.1016/j.hrthm.2025.11.042