Catheter ablation for the treatment of atrial fibrillation is associated with a reduction in health care resource utilization

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Abstract

Background:

Catheter ablation (CA) is superior to antiarrhythmic therapy at reducing recurrence of atrial fibrillation (AF); however, there are limited data regarding whether this decrease translates into a reduction in health care resource utilization.

Objective:

To evaluate the impact of AF ablation on long-term health care resource utilization.

Methods:

A population-based cohort was constructed to include patients who underwent CA for AF in Quebec, Canada, between April 2005 and March 2011. Resource utilization was evaluated 24 months pre- and postindex CA procedure.

Results:

In a cohort of 1,556 patients, resource utilization increased progressively over the 24-month period leading to index CA (P for trend <0.05 for hospitalizations, ER visits, outpatient visits, cardioversions, and echocardiograms). After index CA, all-cause hospitalizations, hospitalizations for AF, ER visits, cardioversions, and echocardiograms were reduced 12 months post-CA compared to 12 months prior (all-cause hospitalizations 0.8–0.6 per patient per year; hospitalizations for AF 0.4–0.3; ER visits 2.9–1.8; cardioversions 0.5–0.2; echocardiograms 0.8–0.5; P < 0.05 for all trends). Resource utilization continued to decline at 24 months post-CA (vs. 12 months prior) for all-cause hospitalizations (0.4), cardioversions (0.1), and echocardiograms (0.3) (per patient year; P < 0.05 for all trends).

Conclusion:

In conclusion, the pattern of increasing health care resource utilization preceding CA for AF reverses after CA to lower than preablation levels up to 24 months post-CA.

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