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J Cardiovasc Electrophysiol ; 26(5): 527-31, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25684120

RESUMEN

BACKGROUND: Despite growing attention to performance and quality measures, national standards for reporting of outcomes after all electrophysiology (EP) procedures have not yet been developed. We sought to characterize the incidence and timing of adverse events up to 30 days after EP procedures at a tertiary academic medical center. METHODS AND RESULTS: We prospectively followed all patients undergoing EP procedures between January 2010 and September 2012. All were followed for 30 days postprocedure either in clinic or by telephone. Major complications were defined as events related to the procedure that led to prolongation of hospital stay or readmission, required additional procedural intervention, or resulted in death or significant injury. These were further categorized as intraprocedure, postprocedure, or postdischarge events. Seven EP physicians collectively adjudicated whether complications were directly related to the procedure. A total of 3,213 procedures were performed. Major complications occurred in 2.2% of patients; 49% of these events occurred after discharge. Death occurred in 0.6% of patients; 73% of these deaths were found to be secondary to worsening of the patient's underlying comorbid conditions and unrelated to the procedure. CONCLUSIONS: When considering national standards for reporting outcomes of all EP procedures, continued follow-up after discharge is important. In our cohort, half of major complications occurring within 30 days occurred after discharge. In addition, three-quarters of deaths within 30 days were not directly related to the procedure and caution should be used in using all-cause mortality as an outcome measure for EP procedures.


Asunto(s)
Centros Médicos Académicos , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/terapia , Cateterismo Cardíaco/mortalidad , Ablación por Catéter/mortalidad , Técnicas Electrofisiológicas Cardíacas/mortalidad , Complicaciones Posoperatorias/mortalidad , Arritmias Cardíacas/mortalidad , Arritmias Cardíacas/fisiopatología , Cateterismo Cardíaco/efectos adversos , Cateterismo Cardíaco/normas , Ablación por Catéter/efectos adversos , Ablación por Catéter/normas , Causas de Muerte , Comorbilidad , Técnicas Electrofisiológicas Cardíacas/efectos adversos , Técnicas Electrofisiológicas Cardíacas/normas , Humanos , Incidencia , Tiempo de Internación , Readmisión del Paciente , Complicaciones Posoperatorias/diagnóstico , Guías de Práctica Clínica como Asunto , Valor Predictivo de las Pruebas , Estudios Prospectivos , Mejoramiento de la Calidad , Indicadores de Calidad de la Atención de Salud , Factores de Riesgo , Centros de Atención Terciaria , Factores de Tiempo , Resultado del Tratamiento , Virginia
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