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AF Ablation Complication Risk Higher at Lower-Volume Centres

MarkS profile image
7 Replies

There's an analysis of ablation complication rates at US centres:

medscape.com/viewarticle/91...

which shows that the rate of complications is much higher at low volume centres.For instance over twice as many strokes and five times more cardiac perforations.

Most of the centres have very low numbers of ablations - over half doing less than 10 a year, so I don't think the results are directly comparable to the UK where I believe volumes are higher? Nevertheless it does show how important experience is in choosing an EP/centre. I would want expect an EP to carry out at least 50 a year. For instance, my EP Prof Richard Schilling carries out more than 150 ablations a year.

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MarkS profile image
MarkS
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7 Replies
BobD profile image
BobDVolunteer

I had a conversation with Rchard Schilling a couple of years ago and he told me very much the same thing about USA Mark. He was actually a lot more forceful but probably here is not the best place to repeat what he said.

I'm surprised if he ony does 150 a year as he said that with the robot he could do three cryos easily in a day (hour and a half each) and I'm sure he works more than one day a week. lol

Out of interest I beleive that there are around 5000 ablations done each year here in UK.

MarkS profile image
MarkS in reply toBobD

I'm sure you're right, Bob. He said he did at least 4 a week so I was a bit conservative. I'm surprised there are only 5000 ablations a year, I would have estimated about twice that off the top of my head.

BobD profile image
BobDVolunteer in reply toMarkS

Could be old news Mark. A couple of years since I saw any data.

IanMK profile image
IanMK in reply toBobD

When I spoke to him last year he told me that he doesn’t have the robot he was trialling any more. I had assumed that it was basically the same type as used in other medical procedures but, in hindsight, perhaps one used for catheter ablations is a different beast.

BobD profile image
BobDVolunteer in reply toIanMK

In fairness it didn't really speed things up, just enabled him to sit remotely and drastically reduce his radiation exposure, thus improving his QOL.

Sunny-fl profile image
Sunny-fl

I wonder how you find the high and low volume centers in the U.S.

Showing yet again how good our NHS centres of specialism are.

Long live the NHS

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