To assess linear trends for complications across years, the Mantel-Haenszel Chi-square test was used. Univariate between-group comparisons were performed using Chi-square tests for categorical and binary variables. After application of the preceding criteria, we further excluded hospitals that performed fewer than 12 procedures during the 6-year study period (i.e., an average of <2 procedures per year) from further analysis in order to avoid distortions from very-low-volume centers and to avoid inclusion of procedures unlikely to be RFA for AF.ĭata are presented as frequencies for all discrete variables. The ICD-9-CM codes used to identify each of these diagnoses and procedures are listed in the Appendix. Cases with open surgical ablations during the hospitalization also were excluded. Also, to avoid including patients undergoing only ablation of the AV junction, we excluded patients with diagnostic or procedural codes indicating prior or current implantation of a pacemaker or implantable cardioverter-defibrillator (ICD). In order to remove ablations for arrhythmias other than AF, we excluded patients having a secondary diagnosis of atrial flutter, Wolff-Parkinson-White syndrome, nonparoxysmal AV nodal tachycardia, paroxysmal supraventricular tachycardia, paroxysmal ventricular tachycardia, and ventricular premature beats.
#Ra ablation for atrial flutter icd 10 pcs code
In order to identify this study population, each MedPAR file was searched for hospital admissions with a principal diagnosis of AF (ICD-9-CM code 427.31) during which a catheter ablation procedure (code 37.34) was performed. Currently, there is no unique procedure code for AF ablation. Our target population consisted of Medicare patients who had undergone RFA for AF from Octoto September 30, 2006. The validity of identifying comorbid conditions from such administrative data has been previously established. For each hospitalization, the MedPAR files contain information on basic patient demographics (age, gender, race) quarter and year the admission and discharge occurred principal discharge diagnosis, coded according to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) up to eight secondary ICD-9-CM diagnosis codes up to six ICD-9-CM procedural codes length of stay and discharge status. short-stay hospitals for services provided to Medicare beneficiaries. MedPAR files contain administrative data for all claims submitted to the Centers for Medicare and Medicaid Services (CMS) by U.S. Medicare beneficiaries, the objectives of this study were to assess trends in the number of hospitals performing RFA for AF and the volume of cases performed to identify the rates of significant procedural complications and changes in these rates over time and to assess variation in complication rates according to patient demographics and clinical characteristics.ĭata for the current analysis were obtained from Medicare Provider Analysis and Review (MedPAR) files for fiscal years 2001–2006. hospitals other than in selected, primarily academic centers. Little is known about the utilization, success rates, and frequency of complications in older patient populations and in U.S.
Furthermore, most studies on the outcomes of AF ablation have included relatively young patients 8 despite the fact that most patients with AF are older than 65 years. Typically, these centers are teaching hospitals that perform a large volume of procedures 7 and therefore might be expected to have better outcomes than smaller, less experienced centers.
The majority of data regarding the safety of RFA for AF come from selected centers with considerable interest and experience in catheter ablation. 2 Reported success rates and complication rates vary widely, with most studies suggesting major complication rates between 1% and 8%. 1 Radiofrequency catheter ablation (RFA) involving, but not limited to, electrical isolation of the pulmonary veins has evolved into an important treatment option for AF, and its utilization also is increasing. Atrial fibrillation (AF) is the most common sustained arrhythmia in humans, and its incidence is increasing.
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