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Updated: Aug 13, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Impact of a dedicated center for atrial fibrillation on resource utilization and costs
Ankit Medhekar1, Suresh Mulukutla2, Whitney Adams2
1Department of Medicine, Section of Cardiology, Baylor College of Medicine, Houston, Texas, USA.
Insights
Referral to a dedicated Atrial Fibrillation (AF) center from the emergency department (ED) significantly cut healthcare costs and hospital stays. This approach improved patient outcomes by reducing overall expenses and admissions for AF patients.
Area of Science:
- Cardiology
- Health Economics
- Healthcare Management
Background:
- Atrial Fibrillation (AF) impacts millions annually, leading to substantial healthcare resource utilization via emergency department (ED) visits and hospitalizations.
- High costs associated with AF management necessitate innovative care models to improve efficiency and patient outcomes.
Purpose of the Study:
- To test the hypothesis that referring patients diagnosed with AF in the ED to a specialized Center for AF would decrease overall healthcare expenditures.
- To evaluate the impact of a dedicated AF center on reducing unnecessary inpatient admissions and improving specialized care delivery.
Main Methods:
- A cohort of 96 patients with new AF diagnoses presenting to the ED were referred to the University of Pittsburgh Center for AF.
- A control group of 96 matched patients was identified for comparison.
- The primary outcome was 30-day total healthcare costs, with secondary outcomes including inpatient and outpatient costs, 90-day costs, and hospital stay characteristics.
Main Results:
- Patients referred to the Center for AF demonstrated significantly lower average 30-day costs ($619 vs. $1252, p < 0.001) compared to controls.
- Cost reduction was primarily driven by decreased ED care expenses, despite slightly higher outpatient costs.
- Referral to the AF center also resulted in lower 30-day hospital admission rates and shorter lengths of stay, with sustained differences at 90 days.
Conclusions:
- Directing ED patients with AF to a specialized Center for AF is an effective strategy for reducing overall healthcare costs.
- This specialized referral pathway significantly decreases inpatient admissions and total hospital length of stay for AF patients.
- Implementing dedicated AF centers can optimize resource utilization and improve the management of atrial fibrillation.
Background:
Atrial fibrillation (AF) affects millions of Americans each year and can lead to high levels of resource utilization through emergency department (ED) visits and inpatient stays.
Hypothesis:
We hypothesized that referral of patients to a dedicated Center for AF from the ED would reduce costs of care.
Methods:
The University of Pittsburgh Center for AF serves as a rapid referral center for patients with AF to avoid unnecessary inpatient admissions and provide specialized care. Patients that presented to the ED with AF and met prespecified criteria were directed to rapid outpatient follow-up instead of inpatient admission. The primary outcome of interest was 30-day total costs. Secondary outcomes included outpatient costs, inpatient costs, 90-day costs, and inpatient stay characteristics.
Results:
We identified 96 patients (median age 65, 38% women) referred to the center for AF for a new diagnosis of AF between October 2017 and December 2019 and matched 96 control patients. After 30 days of follow-up, patients referred to the center for AF had a lower average cost ($619 vs. $1252, p < 0.001) compared to controls, driven by lower costs of ED care tempered by slightly higher outpatient costs. Thirty-day admissions and lengths of stay were also lower. These differences were persistent at 90 days.
Conclusion:
Directing patients with AF that present to the ED to follow-up at a dedicated Center for AF significantly reduced overall costs, while reducing subsequent inpatient admissions and total lengths of stay in the hospital.
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