Dataset Information

Healthcare utilization and cost in patients with atrial fibrillation and heart failure undergoing catheter ablation.

ABSTRACT:

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?ConclusionsCatheter 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.

SUBMITTER: Field ME

PROVIDER: S-EPMC7821325 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Healthcare utilization and cost in patients with atrial fibrillation and heart failure undergoing catheter ablation.

Field Michael E ME Gold Michael R MR Rahman Motiur M Goldstein Laura L Maccioni Sonia S Srivastava Abhishek A Khanna Rahul R Piccini Jonathan P JP Friedman Daniel J DJ

Journal of cardiovascular electrophysiology 20201020 12

<h4>Background</h4>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.<h4>Methods</h4>Using a large United States administrative database, we identified (n = 1568) treated with ablation with a primary and secondary di ...[more]

PMID: 33022815

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Project description:OBJECTIVES:Assessing the cost-effectiveness credentials of this intervention in patients with concomitant atrial fibrillation (AF) and heart failure (HF) compared with usual medical therapy. DESIGN:A Markov model comprising two health states (ie, alive or dead) was constructed. The transition probabilities were directly derived from published Kaplan-Meier curves of the pivotal randomised controlled trial and extrapolated over the cohort's lifetime using recommended methods. Costs of catheter ablation, outpatient consultations, hospitalisation, medications and examinations were included. Resource use and unit costs were sourced from government websites or published literature. A lifetime horizon and a healthcare system perspective were taken. All costs and benefits were discounted at 3% annually. Deterministic (DSA) and probabilistic sensitivity analyses (PSA) were run around the key model parameters to test the robustness of the base case results. PARTICIPANTS:A hypothetical Australian cohort of patients with concomitant AF and HF who are resistant to antiarrhythmic treatment. INTERVENTIONS:Catheter ablation versus medical therapy. RESULTS:The catheter ablation was associated with a cost of $A44 377 per person, in comparison to $A28 506 for the medical therapy alone over a lifetime. Catheter ablation contributed to 4.58 quality-adjusted life years (QALYs) and 6.99 LY gains compared with 4.30 QALYs and 6.53 LY gains, respectively, in the medical therapy arm. The incremental cost-effectiveness ratio was $A55 942/QALY or $A35 020/LY. The DSA showed that results were highly sensitive to costs of ablation and time horizon. The PSA yielded very consistent results with the base case. CONCLUSIONS:Offering catheter ablation procedure to patients with systematic paroxysmal or persistent AF who failed to respond to antiarrhythmic drugs was associated with higher costs, greater benefits. When compared with medical therapy alone, this intervention is not cost-effective from an Australia healthcare system perspective.

Dataset Information

Healthcare utilization and cost in patients with atrial fibrillation and heart failure undergoing catheter ablation.

Background

Methods

Results

Publications

Healthcare utilization and cost in patients with atrial fibrillation and heart failure undergoing catheter ablation.

Similar Datasets

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