Background:
Premature ventricular contractions (PVCs) occur both in patients with and without structural heart disease (SHD), particularly in ischemic heart disease (ICM) and dilated cardiomyopathy (DCM). The underlying substrate localization and ablation strategies differ according to aetiology. The present analysis aimed to evaluate, using nationwide inpatient billing data, the ablation site, catheter technology, periprocedural complication rates, and average hospital length of stay.
Methods and Results:
Nationwide inpatient billing data according to §21 KHEntgG were retrospectively analyzed within the framework of the German Ablation Registry between January 1, 2018, and December 31, 2023. A total of 1,753 PVC ablations from 13 centers were included, comprising 620 patients with SHD (448 ICM, 172 DCM) and 1,133 with idiopathic PVCs. Subgroup comparisons were performed using Pearson’s chi-squared test and the Kruskal–Wallis test, with stepdown Bonferroni-Holm correction for multiple testing. Patients with SHD were older, more often male, and had a higher prevalence of cardiopulmonary and metabolic comorbidities such as diabetes mellitus and arterial hypertension. PVC ablations in SHD patients were performed significantly more often in the left ventricle (75.2% vs. 51.0%, p < 0.001). Contact force–sensing ablation catheters were also used more frequently in SHD (36.6% vs. 26.7%, p < 0.001). The mean hospital stay was longer in SHD patients (3.4 ± 4.2 days vs. 2.4 ± 2.7 days, p < 0.001). The overall complication rates did not differ significantly between groups (7.9% vs. 8.0%, p = 0.924), and no in-hospital deaths occurred.
Conclusion:
These real-world data from the German Ablation Registry demonstrate relevant differences in patient characteristics and procedural characteristics between SHD-related and idiopathic PVC ablations. More frequent left ventricular ablation and use of contact force–sensing catheters reflect the greater substrate complexity in SHD. Due to the older and more comorbid patient population, PVC ablation in SHD was associated with a prolonged hospital stay. However, this was not accounted for by a higher complication rate. Notably, no in-hospital deaths occurred in either group, underscoring the overall safety of PVC ablation in contemporary clinical practice. Due to the retrospective nature of the analysis, these findings need to be interpreted with caution. Future studies should specifically address differences in ablation success and long-term clinical outcomes.
