Atrial fibrillation ablation leads to long-term improvement of quality of life and reduced utilization of healthcare resources.
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.
Goldberg
Andrea
A
Electrophysiology and Pacing Service, Department of Cardiology, Lovelace Medical Center, Albuquerque, NM 87108, USA.
Menen
Michael
M
Mickelsen
Steven
S
MacIndoe
Chamisa
C
Binder
Mario
M
Nawman
Rosella
R
West
Gail
G
Kusumoto
Fred M
FM
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