Impact of chronic kidney disease on in-hospital mortality and clinical
outcomes of catheter ablation of ventricular tachycardia: Insights from
the national readmission database
Abstract
Background: Catheter ablation is an effective treatment for ventricular
tachycardia (VT), albeit the decision to undergo this procedure is often
influenced by underlying comorbidities. The present study aims at
evaluating the effects of chronic kidney disease (CKD) on clinical
outcomes of VT ablation. Methods: We identified 7,212 patients who
presented between 2016-2018 and underwent catheter ablation for VT.
Their clinical data were retrospectively accrued from the national
readmission database (NRD) using the corresponding diagnosis codes. We
compared clinical outcomes between patients with chronic kidney disease
(CKD-group) and patients without. Odds ratios (OR) for the primary and
secondary outcomes were calculated, and multivariable regression
analysis was utilized to adjust for confounding variables. Results:
Compared with patients without CKD, patients in CKD-group were older
(mean age 67.9 vs. 60.5 years, P <0.01), had a longer mean
length of stay (8.73 vs. 5.69 days, P <0.01), and higher
in-hospital mortality (OR 2.24, 95% confidence interval (CI)
(1.29-3.88), P<0.01). CKD-group patients had increased risk of
developing acute kidney injury (10% vs. 8.6%, P<0.01) and
30-day readmission rate due to VT (OR 1.77, 95% CI (1.17-2.69),
P<0.01). Conclusion: In patients with CKD, VT ablation is
associated with worse clinical outcomes in-hospital mortality and 30-day
readmission rate. This significantly influences the decision-making
prior to performing this procedure.