Premium
Healthcare utilization and cost in patients with atrial fibrillation and heart failure undergoing catheter ablation
Author(s) -
Field Michael E.,
Gold Michael R.,
Rahman Motiur,
Goldstein Laura,
Maccioni Sonia,
Srivastava Abhishek,
Khanna Rahul,
Piccini Jonathan P.,
Friedman Daniel J.
Publication year - 2020
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14774
Subject(s) - medicine , atrial fibrillation , catheter ablation , ablation , emergency medicine , management of atrial fibrillation , healthcare cost and utilization project , cohort , population , cardiology , health care , environmental health , economics , economic growth
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.