Michelle Samuel1, Meytal Avgil Tsadok1, Jacqueline Joza2, Hassan Behlouli1, Atul Verma2, Vidal Essebag2, Louise Pilote1,3. 1. Division of Clinical Epidemiology, McGill University Health Centre Research Institute, Montreal, Quebec, Canada. 2. Division of Cardiology, McGill University Health Centre Research Institute, Montreal, Quebec, Canada. 3. Division of General Internal Medicine, McGill University Health Centre Research Institute, Montreal, Quebec, Canada.
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.
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.