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Updated: May 5, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
A Cost Analysis of Catheter Ablation for Atrial Fibrillation: A Canadian Pre-Post Study
Yousef N Bolous1, Prosper Koto2, John L Sapp3
1Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Insights
Catheter ablation (CA) for atrial fibrillation (AF) may be cost-effective despite initial expenses. Post-ablation care shows reduced healthcare utilization and costs compared to pre-ablation periods.
Area of Science:
- Cardiology
- Health Economics
Background:
- Limited Canadian patient-level data exists on catheter ablation (CA) costs for atrial fibrillation (AF).
- Understanding healthcare resource utilization and cost predictors for CA is crucial.
Purpose of the Study:
- To identify healthcare resource use, costs, and cost predictors associated with catheter ablation (CA) for atrial fibrillation (AF) in Canada.
Main Methods:
- A cost analysis was conducted on AF patients undergoing CA in Nova Scotia (2010-2018).
- Costs were compared two years pre-CA versus two years post-CA, with a defined 3-month treatment window.
- Costs were also analyzed based on CA technology (pre- and post-2015).
Main Results:
- Heart failure hospitalizations, ED visits, inpatient admissions, and cardioversions decreased post-CA.
- Overall costs increased by CAD$18,869 post-CA, primarily driven by the treatment window ($21,439).
- Excluding the treatment window, Year 1 post-CA costs ($11,223) and Year 2 post-CA costs ($4555) were lower than pre-CA costs. New technologies did not influence costs.
Conclusions:
- Catheter ablation (CA) for AF, while initially expensive, demonstrates potential cost-effectiveness.
- Significant reductions in healthcare resource use and associated costs are observed post-ablation, suggesting long-term value.
Background:
There is a paucity of Canadian studies using patient-level data to analyze the costs of catheter ablation (CA) for atrial fibrillation (AF). We sought to identify the health care resource use, costs, and cost predictors of CA.
Methods:
A cost analysis was performed in a population of AF patients treated with CA in Central Zone Nova Scotia from 2010 to 2018. Costs were compared 2 years before ablation (pre-CA) with costs 2 years after (post-CA); the 3-month period post-CA was defined as the treatment window. Costs were also compared according to CA technology defined as before 2015 for patients treated with non-contact force sensing CA and after 2015 for patients treated with contact force sensing CA.
Results:
Heart failure hospitalizations, AF-related emergency department visits, acute inpatient admissions, and cardioversions all decreased after ablation. The cost difference post-CA vs pre-CA was CAD$18,869 (95% confidence interval [CI], $15,570-$22,168). This increase in costs was driven by costs incurred during the treatment window, which was $21,439 (95% CI, $20,468-$22,409). After excluding treatment window costs, the mean year 1 post-CA cost was $11,223 (95% CI, $9113-$13,334) and year 2 post-CA cost was $4555 (95% CI, $3145-$5965); both were lower than the pre-CA costs. Costs remained stable over the time frame of the study period, with no influence from new technologies on cost. The post-CA cost difference between the post-2015 and pre-2015 groups was $2573 (95% CI, -$2336 to $7481).
Conclusions:
We showed that although CA is expensive, it might be a cost-effective treatment modality for AF because of the associated reduction in costs and health care resource use.
