TY  - BOOK
AU  - Basyal, Binaya
AU  - Oates, Connor
TI  - Trends in safety of catheter-based electrophysiology procedures in the last 2 decades: A meta-analysis
SN  - 1547-5271
PY  - 2024///
KW  - IN PROCESS -- NOT YET INDEXED
KW  - Automated
KW  - MedStar Washington Hospital Center
KW  - Cardiovascular Disease Fellowship
KW  - Clinical Cardiac Electrophysiology Fellowship
KW  - Journal Article
N1  - Available online through MWHC library: 2004 - present
N2  - BACKGROUND: Rapid technologic development and expansion of procedural expertise have led to widespread proliferation of catheter-based electrophysiology procedures. It is unclear whether these advances come at cost to patient safety; CONCLUSION: Despite an increase in cardiac electrophysiology procedures, procedural safety has improved over time. Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved; METHODS: A comprehensive search was performed to identify relevant data published before May 30, 2023. Studies were included if they met the following inclusion criteria: prospective trials or registries, including comprehensive complications data; and patients undergoing atrial fibrillation ablation, ventricular tachyarrhythmia ablation, leadless cardiac pacemaker implantation, and percutaneous left atrial appendage occlusion. Pooled incidences of procedure-related complications were individually assessed by random effects models to account for heterogeneity. Temporal trends in complications were investigated by clustering trials by publication year (2000-2018 vs 2019-2023); OBJECTIVE: This meta-analysis aimed to assess complication rates after modern electrophysiology procedures during the lifetime of the procedures; RESULTS: A total of 174 studies (43,914 patients) met criteria for analysis: 126 studies of atrial fibrillation ablation (n = 24,057), 25 studies of ventricular tachyarrhythmia ablation (n = 1781), 21 studies of leadless cardiac pacemaker (n = 8896), and 18 studies of left atrial appendage occlusion (n = 9180). The pooled incidences of serious procedure-related complications (3.49% [2000-2018] vs 3.05% [2019-2023]; P < .001), procedure-related stroke (0.46% vs 0.28%; P = .002), pericardial effusion requiring intervention (1.02% vs 0.83%; P = .037), and procedure-related death (0.15% vs 0.06%; P = .003) significantly decreased over time. However, there was no significant difference in the incidence of vascular complications over time (1.86% vs 1.88%; P = .888)
UR  - https://dx.doi.org/10.1016/j.hrthm.2024.03.043
ER  -