VT ablation registry needed to track ‘exponential growth’ in procedures


By Michael Woodhead

19 Sep 2019

The last decade has seen exponential growth in catheter ablation procedures for ventricular tachycardia in Australia, surpassing trends for interventions such as AF ablation and PCI, new figures show.

With VT ablation procedure numbers increasing by 18% a year there is a need for additional resourcing, training and a national registry to keep track of procedural techniques and outcomes, according to cardiologist Dr Robert Anderson and colleagues at Melbourne and Sydney universities.

Using data from the Australian Institute of Health and Welfare (AIHW) and Medicare Australia they found that VT ablation procedure numbers increased by between 12.7% and 18.0% between 2008/9 and 2016/17.

In comparison, rates of AF ablations rose by 11.7% to 12.7% a year while PCI rates showed only 1.3% to 1.8% annual incremental rises over the same period.

Writing in the Journal of Cardiovascular Electrophysiology, Dr Anderson and colleagues said that while absolute numbers of VT ablation procedures were low compared to other interventions, the substantial increase in demand had important implications for cardiology centres with VT ablation programs “highlighting the need for additional resource allocation, funding, and staff training in the procedural management of this high‐risk patient group.”

The steep rise in VT ablations mirrored the increases seen in other countries and was likely due to factors such as increasing rates of ICD implantation resulting in better VT detection and increased survival, leading to more people with VT being referred for treatment.

Advances in technology over the last decade had resulted in sophisticated anatomical mapping and catheter ablation techniques that offered more rapid, safer and efficacious procedures, they noted.

As such, it was likely that VT ablation was being recommended to increasing numbers of people who had drug-refractory VT, they said.

The procedure was complex and had high upfront costs but would result in a lower burden of VT recurrence with consequent reductions in costs for rehospitalisation and other healthcare utilisation, as well as improving patient quality of life and avoiding anti-arrhythmic drug side effects, the study authors said.

“Most tertiary Australian electrophysiology centres now have a VT ablation program; but given the diversity in procedural strategies and endpoints, a collaborative registry to appraise procedural numbers, techniques and outcomes are lacking.

“A prospective, procedure-specific nationwide registry is needed to accurately assess procedural trends and provide greater insight of outcomes in an unselected “real‐world” population undergoing VT ablation.”

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