Septal Ablation and Hypertrophic Obstructive Cardiomyopathy: 7 Years US Experience

Ankit Chothani; Sidakpal S Panaich; Nilay Patel; Nileshkumar J Patel; Shilpkumar Arora; Abhishek Deshmukh; Cindy Grines; Apurva O Badheka

doi:10.1111/joic.12319

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Septal Ablation and Hypertrophic Obstructive Cardiomyopathy: 7 Years US Experience

Journal article

Open access

Peer reviewed

Septal Ablation and Hypertrophic Obstructive Cardiomyopathy: 7 Years US Experience

Ankit Chothani, Sidakpal S Panaich, Nilay Patel, Nileshkumar J Patel, Shilpkumar Arora, Abhishek Deshmukh, Cindy Grines and Apurva O Badheka

Journal of interventional cardiology, Vol.29(5), pp.505-512

10/2016

DOI: 10.1111/joic.12319

PMID: 27545515

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Abstract

Septal ablation (SA) is a key modality for left ventricular outflow tract gradient reduction in hypertrophic obstructive cardiomyopathy (HOCM) patients with refractory symptoms. The primary objective of our study was to evaluate post-procedural mortality, complications, length of stay (LOS), and cost of hospitalization following SA. We queried the Nationwide Inpatient Sample (NIS) between 2005 and 2011 using the ICD9 procedure code of 37.34 for ablation of heart tissue. Only adult patients with HOCM (ICD-9-CM: 425.1) were included. Patients with any arrhythmia diagnosis or open surgical ablation procedure code were excluded. Hierarchical mixed effects models were generated in order to identify the independent multivariate predictors of outcomes. A total of 358 SAs were available for analysis. There was no reported mortality during the study period; permanent pacemaker implantation rate was 8.7%. Highest hospital volume tertile (OR, 95%CI, P- value) predicted significantly lower post-procedural complications (0.51, 0.26-0.98, P = 0.04). Univariate analysis of highest versus lowest tertile of hospital volume showed significant decrease in LOS (2.6 days vs. 3.8 days, P<0.01) and non-significant decrease hospitalization costs (16,800$ vs. 19,500$, P = 0.29). SA is a safe procedure and associated with low peri- procedural mortality rate. A higher burden of baseline comorbidities is associated with worse outcomes while higher annual hospital volume is associated with lower rate of post-procedural complications, length of stay, and cost of care following SA.

Heart Septum - diagnostic imaging

United States - epidemiology

Ventricular Outflow Obstruction - surgery

Postoperative Complications - etiology

Cardiomyopathy, Hypertrophic - surgery

Humans

Middle Aged

Male

Postoperative Complications - epidemiology

Cardiomyopathy, Hypertrophic - diagnosis

Ventricular Outflow Obstruction - etiology

Postoperative Complications - diagnosis

Catheter Ablation - methods

Cardiomyopathy, Hypertrophic - mortality

Outcome and Process Assessment (Health Care)

Cardiomyopathy, Hypertrophic - physiopathology

Adult

Female

Aged

Retrospective Studies

Catheter Ablation - adverse effects

Heart Septum - surgery

Length of Stay - statistics & numerical data

Hospitalization - economics

Details

Title: Subtitle: Septal Ablation and Hypertrophic Obstructive Cardiomyopathy: 7 Years US Experience
Creators: Ankit Chothani - Mount Sinai St. Luke's Roosevelt Hospital, New York, New York
Sidakpal S Panaich - Borgess Medical Institute, Kalamazoo, Michigan
Nilay Patel - Saint Peter's University Hospital, New Brunswick, New Jersey
Nileshkumar J Patel - University of Miami Miller School of Medicine, Miami, Florida
Shilpkumar Arora - Mount Sinai St. Luke's Roosevelt Hospital, New York, New York
Abhishek Deshmukh - Mayo Clinic, Rochester, Minnesota
Cindy Grines - Detroit Medical Center, Detroit, Michigan
Apurva O Badheka - The Everett Clinic, Everett, Washington. abadheka@everettclinic.com
Resource Type: Journal article
Publication Details: Journal of interventional cardiology, Vol.29(5), pp.505-512
DOI: 10.1111/joic.12319
PMID: 27545515
NLM abbreviation: J Interv Cardiol
ISSN: 0896-4327
eISSN: 1540-8183
Language: English
Date published: 10/2016
Academic Unit: Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984094503602771

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