Catheter ablation is an effective treatment for patients with atrial fibrillation (AF) and heart failure (HF). However, little is known 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.
Using a large US administrative database, we identified (n=1,568) treated with ablation with a primary and secondary diagnosis of AF and HF, respectively, were evaluated 1-year pre- and post-ablation 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 post-ablation.
Reductions were observed in AF-related admissions (64%), LOS (65%), cardioversions (52%), ED visits (51%, all values, p<0.0001), and HF-related admissions (22%, p=0.01). There was a 40% reduction in inpatient admission cost ($4,165 pre-ablation to $2,510 post-ablation, p<0.0001). In a sensitivity analysis excluding repeat-ablation patients, greater reduction in overall AF management cost was observed compared to the full cohort (-43% vs -2%). Comparing 1-year pre- to 3-years post-ablation, both total mean AF-management cost ($850 per-patient per-month 1-year pre- to $546 3-years post-ablation, p<0.0001) and AF-related healthcare utilization was reduced.
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 positive impact of ablation on longer-term cost reduction. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.