title: Atrial fibrillation ablation leads to long-term improvement of quality of life and reduced utilization of healthcare resources.
abstract: In some patients, rapid activation from one or several foci can lead to atrial fibrillation. This study evaluated long-term changes in quality of life and healthcare resource utilization in patients with atrial fibrillation treated by ablation of focal triggers. Thirty-three patients underwent ablation for paroxysmal atrial fibrillation. Health surveys (SF-36) were obtained at baseline, and after 1 year and 3 years of follow-up. Health care costs were measured for the 3 years before and after ablation. Ablation was successful in 82%, partially successful in 12% (no sustained episodes but on antiarrhythmic drug therapy), and unsuccessful in 6% of patients. The average number of ablation procedures was 1.6 +/- 0.6 per patient. After ablation, patients reported significantly improved quality of life in all SF-36 categories except bodily pain. Healthcare resource utilization was significantly reduced after ablation (Clinic visits: 7.4 +/- 2.5 per year vs. 1.1 +/- 0.6 per year, p < 0.05; Emergency room visits: 1.7 +/- 0.90 per year vs. 0.03 +/- 0.17 per year, p < 0.05; Hospitalization: 1.6 +/- 0.81 vs. 0, p < 0.05). Cost of healthcare (not including procedural costs) was significantly reduced after ablation (Pre-ablation: 1,920 +/- 889 dollars/year vs. post-ablation: 87 +/- 68 dollars/year; p < 0.01). Procedural cost of ablation was 17,173 +/- 2,466 dollars/patient. Ablation of focal triggers of atrial fibrillation is associated with a sustained improvement in quality of life. Although the initial cost of ablation is high, after ablation, utilization of healthcare resources is significantly reduced.
authors.affiliation: Electrophysiology and Pacing Service, Department of Cardiology, Lovelace Medical Center, Albuquerque, NM 87108, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Goldberg
authors.forename: Michael
authors.initials: M
authors.lastname: Menen
authors.forename: Steven
authors.initials: S
authors.lastname: Mickelsen
authors.forename: Chamisa
authors.initials: C
authors.lastname: MacIndoe
authors.forename: Mario
authors.initials: M
authors.lastname: Binder
authors.forename: Rosella
authors.initials: R
authors.lastname: Nawman
authors.forename: Gail
authors.initials: G
authors.lastname: West
authors.forename: Fred M
authors.initials: FM
authors.lastname: Kusumoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000191:economics / Q000601:surgery*; D017115:Catheter Ablation / Q000191:economics; D003365:Costs and Cost Analysis; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006295:Health Resources / Q000592:standards / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009516:New Mexico; D011183:Postoperative Complications / Q000191:economics / Q000209:etiology / Q000503:physiopathology; D011788:Quality of Life / Q000523:psychology; D012008:Recurrence; D012086:Reoperation; D013318:Stroke Volume / Q000502:physiology; D013995:Time; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000191:economics / Q000601:surgery