Sex, Race, and Rural-Urban Disparities in Ventricular Tachycardia Ablations

JACC Clin Electrophysiol. 2024 Oct;10(10):2148-2154. doi: 10.1016/j.jacep.2024.05.033. Epub 2024 Aug 7.

Abstract

Background: Ventricular ablation may be clinically indicated for patients with recurrent ventricular tachycardia (VT) and has been shown to decrease risk of recurrence and overall morbidity. However, the existence of disparities among patients receiving ventricular ablation has not been well characterized.

Objectives: In this study, the authors examined patients hospitalized with VT to determine whether disparities exist among those receiving ablations.

Methods: The authors used the National Inpatient Sample to assess patients hospitalized with a primary diagnosis of VT in 2019 who did and did not receive catheter ablations. Multiple logistic regression was used to calculate risk factors for VT ablation based on age, sex, race/ethnicity, socioeconomic status, and hospital characteristics.

Results: After adjusting for baseline characteristics and comorbidities, female and Black patients hospitalized with VT had significantly lower odds of receiving ablations compared with male and White patients (OR: 0.835; 95% CI: 0.699-0.997; P = 0.047; and OR: 0.617; 95% CI: 0.457-0.832; P = 0.002, respectively). Additionally, patients at rural or nonteaching hospitals were significantly less likely to receive ablations compared with those at urban, teaching hospitals. No significant differences were noted based on income or insurance status in the adjusted models.

Conclusions: The authors identified significant disparities in the delivery of ventricular ablations among patients hospitalized with VT. Overall, patients who were female or Black as well as those who were hospitalized at rural or nonteaching hospitals were significantly less likely to receive VT ablations during hospitalization.

Keywords: catheter ablation; disparities; ventricular tachycardia.

MeSH terms

  • Adult
  • Aged
  • Catheter Ablation* / statistics & numerical data
  • Female
  • Healthcare Disparities* / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Sex Factors
  • Tachycardia, Ventricular* / epidemiology
  • Tachycardia, Ventricular* / surgery
  • United States / epidemiology