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. 2023 Aug 30;39(5):790-798.
doi: 10.1002/joa3.12911. eCollection 2023 Oct.

Predictors of morbidity and in-hospital mortality following procedure-related cardiac tamponade

Saurabh Deshpande  1 , Hiroyuki Swatari  2   3 , Raheel Ahmed  4 , George Collins  5 , Mohammed Y Khanji  6 , Virend K Somers  2 , Anwar A Chahal  6   7 , Deepak Padmanabhan  1   2
Affiliations

Predictors of morbidity and in-hospital mortality following procedure-related cardiac tamponade

Saurabh Deshpande et al. J Arrhythm. .

Abstract

Background: Cardiac tamponade (CT) can be a complication following invasive cardiac procedures. We assessed CT following common cardiac electrophysiology (EP) procedures to facilitate risk prediction of associated morbidity and in-hospital mortality.

Methods: Patients who underwent various EP procedures in the cardiac catheterization lab (ablations and device implantations) were identified using the International Classification of Diseases, Ninth and Tenth Edition, Clinical Modification (ICD-9-CM and ICD-10-CM, respectively) from the Nationwide Inpatient Sample (NIS) database. Patient demographics, presence of comorbidities, CT-related events, and in-hospital death were also abstracted from the NIS database.

Results: The frequency of CT-related events in patients with EP intervention from 2010 to 2017 ranged from 3.4% to 7.0%. In-hospital mortality related to CT-related events was found to be 2.2%. Increasing age was the only predictor of higher mortality in atrial fibrillation (AF) ablation and cardiac resynchronization therapy (CRT) groups (OR [95% CI]: AF ablation = 11.15 [1.70-73.34], p = .01; CRT = 1.41 [1.05-1.90], p = .02).

Conclusions: In the real-world setting, CT-related events in EP procedures were found to be 3.4%-7.0% with in-hospital mortality of 2.2%. Older patients undergoing AF ablation were found to have higher mortality.

Keywords: cardiac tamponade; electrophysiological procedures; mortality.

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Conflict of interest statement

Authors declare no conflict of interests for this article.

Figures

FIGURE 1
FIGURE 1
Study flow diagram. AF, atrial fibrillation; AFL, atrial flutter; CRT‐D, cardiac resynchronization therapy‐defibrillator; CRT‐P, cardiac resynchronization therapy‐pacemaker; CTO, chronic total occlusion; EP, electrophysiological procedure; ICD, implantable cardioverter defibrillator; LAA, left atrial appendage; LOS, length of stay; N, number; PPM, pacemaker; PTCA, percutaneous transluminal coronary angioplasty; SVT, supraventricular tachycardia; VT, ventricular tachycardia.
FIGURE 2
FIGURE 2
Temporal trends of cardiac intervention‐related events in the patients who underwent coronary or electrophysiological interventions. (A) Trends of cardiac intervention‐related cardiac events in the patients undergoing electrophysiological procedures. (B) Trends of cardiac intervention related cardiac events in the groups stratified by types of electrophysiological procedures. Events: cardiac tamponade, hemopericardium, acute posthemorrhagic anemia, hemorrhage/hematoma complicating a procedure. AF, atrial fibrillation; AFL, atrial flutter; CRT‐D, cardiac resynchronization therapy‐defibrillator; CRT‐P, cardiac resynchronization therapy‐pacemaker; EP, electrophysiological procedure; ICD, implantable cardioverter defibrillator; LAA, left atrial appendage; PPM, pacemaker; SVT, supraventricular tachycardia; VT, ventricular tachycardia.
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