Ventricular tachycardia ablation across age groups: Outcomes, trends and demographics. Insights from the National Inpatient Sample Database

Background

Ventricular tachycardia ablation (VTA) is an important treatment option for ventricular tachycardia, with increasing use across all age groups. However, age-related differences in outcomes remain a concern.

Objective

This study aimed to investigate age-related trends in VTA procedures and their associated adverse events across the United States from 2011 to 2021. The primary objective was to analyze VTA outcomes across different age groups. Secondary objectives included examining variation in VTA rate by sex and geographic region.

Methods

We conducted a retrospective analysis of the National Inpatient Sample, focusing on adult patients (≥18 years of age) hospitalized with a primary diagnosis of ventricular tachycardia. Patients were divided into 3 age groups: ≤59, 60 to 79, and ≥80 years. We evaluated VTA frequency, in-hospital mortality, and complications using propensity score matching to control for confounders. Secondary analyses examined sex and geographic differences.

Results

The study included 95,913 VTA procedures. The mean age of patients undergoing VTA increased over time, with a growing proportion of procedures performed in older patients. While overall adverse events did not significantly differ across age groups, specific outcomes such as mortality and hemorrhage were significantly higher in patients ≥80 years of age. In-hospital mortality was highest in the ≥80 years age group (5.1%), compared with 1.6% in the ≤59 years age group and 2.7% in the 60 to 79 years age group. Significant differences by sex and region were also observed.

Conclusion

Our study demonstrates that while the overall incidence of adverse events with VTA did not significantly increase with age, specific severe outcomes, such as in-hospital mortality and hemorrhage, were more prevalent in older patients. These findings suggest that VTA can be safely performed across age groups, but careful consideration is essential for elderly patients. Future research should focus on understanding the impact of age-related physiological changes and comorbidities on VTA outcomes.