Abstract 4132217: Comorbidities Associated with One Year Mortality and Hospital Readmission After Ventricular Tachycardia Ablation

Introduction: Many studies have evaluated outcomes after ventricular tachycardia (VT) ablation though few studies have evaluated outcomes past thirty days. This study aimed to determine which comorbidities are associated with one-year readmissions and mortality after VT ablation, including socioeconomic disadvantage (SED) via the Area Deprivation Index (ADI). Methods: Patients ages ≥18 were identified in the Healthcare Cost and Utilization Project State Inpatient Databases in New York and Florida from 2016-2019 with follow-up into 2020. These states were chosen due to availability for linkage of the 2020 ADI (1-100, higher scores representing more disadvantage). International Classification of Diseases 10 codes for VT and VT ablation were used. Patients undergoing pacemaker placement or with other arrhythmias were excluded. The risk of readmission and mortality was assessed using Cox proportional hazards first in an unadjusted fashion for each comorbidity in the Charlson Comorbidity Index. In addition to demographic variables, only significant variables from the unadjusted analysis were included in the final adjusted multivariable models. Results: 1,798 patients met inclusion criteria. The readmission and mortality rates at one, three, and twelve months were 18.5%, 27.4%, 41.4% and 3.5%, 4.1%, 6.5%, respectively. Common diagnoses for readmission were VT (24.8%) and dyspnea/chest pain (10.7%). After adjustment, African American race, federal insurance, heart failure (CHF), vascular disease, renal disease (CKD), severe liver disease (SLD), and higher ADI were associated with increased risk for twelve-month readmissions. Federal insurance, CHF, cerebrovascular disease, dementia, peptic ulcer disease, CKD, and SLD were associated with increased risk for twelve-month mortality. Conclusion: CHF and CKD increased the risk of readmission and mortality. Recurrent VT was the most common cause of readmission. Patients of SED are at increased risk of readmissions within one year.