Healthcare utilization and cost in patients with atrial fibrillation and heart failure undergoing catheter ablation.

Journal Article (Journal Article)

Background

Catheter ablation is an effective treatment for patients with atrial fibrillation (AF) and heart failure (HF). However, little is known about how healthcare utilization and cost change after ablation in this population. We sought to determine healthcare utilization and cost patterns among patients with AF and HF undergoing ablation.

Methods

Using a large United States administrative database, we identified (n = 1568) treated with ablation with a primary and secondary diagnosis of AF and HF, respectively, were evaluated 1-year pre- and postablation for outcomes including inpatient admissions (AF or HF), emergency department (ED) visits, cardioversions, length of stay (LOS), and cost. A secondary analysis was extended to 3-years postablation.

Results

Reductions were observed in AF-related admissions (64%), LOS (65%), cardioversions (52%), ED visits (51%, all values, p < .0001), and HF-related admissions (22%, p = .01). There was a 40% reduction in inpatient admission cost ($4165 preablation to $2510 postablation, p < .0001). In a sensitivity analysis excluding repeat-ablation patients, a greater reduction in overall AF management cost was observed compared to the full cohort (-43% vs. -2%). Comparing 1-year pre- to 3-years postablation, both total mean AF-management cost ($850 per-patient per-month 1-year pre- to $546 3-years postablation, p < .0001) and AF-related healthcare utilization was reduced.

Conclusions

Catheter ablation in patients with AF and HF resulted in significant reductions in healthcare utilization and cost through 3-years of follow-up. This reduction was observed regardless of whether repeat ablation was performed, reflecting the positive impact of ablation on longer term cost reduction.

Full Text

Duke Authors

Cited Authors

  • Field, ME; Gold, MR; Rahman, M; Goldstein, L; Maccioni, S; Srivastava, A; Khanna, R; Piccini, JP; Friedman, DJ

Published Date

  • December 2020

Published In

Volume / Issue

  • 31 / 12

Start / End Page

  • 3166 - 3175

PubMed ID

  • 33022815

Pubmed Central ID

  • PMC7821325

Electronic International Standard Serial Number (EISSN)

  • 1540-8167

International Standard Serial Number (ISSN)

  • 1045-3873

Digital Object Identifier (DOI)

  • 10.1111/jce.14774

Language

  • eng