Spanish catheter ablation registry. 24th official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2024).

INTRODUCTION

This report presents the results of the Spanish catheter ablation registry for 2024.

METHODS

A retrospective analysis of ablation procedures performed at participating hospitals in Spain. Data were collected through the REDCap platform using a dedicated form.

RESULTS

There was a significant increase in both the number of participating centers (117 centers,+12.5%) and the total number of ablations performed (32 406,+23%). The most common arrhythmogenic substrate was atrial fibrillation (13 395 cases,+35%, accounting for 41% of all cases), with the single-shot technique being the most widely used (55%). There was also a marked increase in the use of electroporation (21% in 2024 vs 10.3% in 2023). Other substrates showed smaller increases, with cavotricuspid isthmus ablation maintaining its position as the second most common procedure (6084 cases, 19%). Overall acute success rates remained high (95%), and complication (1.5%) and mortality (0.04%) rates were stable. The use of electroanatomical navigation remained consistent (54% of cases), with 17% of procedures performed without fluoroscopy. Outpatient procedures accounted for 18% of the total, with notable percentages for atrioventricular nodal re-entrant tachycardia (39%) and cavotricuspid isthmus ablation (33%). A total of 523 pediatric ablations were performed in 44 centers, predominantly for accessory pathways (66.5%), with a 92.5% success rate. Accreditation activity showed 41 centers and 250 professionals involved.

CONCLUSIONS

The number of centers and procedures increased, mainly due to atrial fibrillation ablation. Despite the growing complexity of cases, the rates of success, complications, and mortality remained stable. The accreditation process for both centers and professionals is now firmly established, with steady annual accreditation numbers.