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Published on: May 26, 2015
Healthcare utilization and cost in patients with atrial fibrillation and heart failure undergoing catheter ablation
Michael E Field1, Michael R Gold1, Motiur Rahman2
1Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina, USA.
Insights
Catheter ablation significantly reduces healthcare utilization and costs for patients with atrial fibrillation (AF) and heart failure (HF). This effective treatment leads to fewer hospital admissions, emergency visits, and lower overall expenses over three years.
Area of Science:
- Cardiology
- Health Economics
- Medical Interventions
Background:
- Atrial fibrillation (AF) and heart failure (HF) are common conditions.
- Catheter ablation is a recognized treatment for AF, but its impact on healthcare utilization and costs in patients with co-existing HF is less understood.
Purpose of the Study:
- To evaluate healthcare utilization and cost patterns in patients with both AF and HF following catheter ablation.
Main Methods:
- A retrospective analysis of a large US administrative database.
- Included 1568 patients with AF and HF undergoing ablation.
- Assessed outcomes 1-year pre- and post-ablation, extending to 3-years for a subset.
Main Results:
- Significant reductions observed in AF-related admissions (64%), length of stay (65%), cardioversions (52%), and ED visits (51%).
- HF-related admissions decreased by 22%.
- Inpatient costs reduced by 40% ($4165 to $2510), with sustained reductions in AF management costs over 3 years.
Conclusions:
- Catheter ablation leads to substantial decreases in healthcare utilization and associated costs for patients with AF and HF.
- These benefits are evident up to 3 years post-procedure, irrespective of repeat ablations, highlighting its long-term economic value.
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.
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