title: Adverse psychological effects and costs associated with waiting for radiofrequency ablation.
abstract: BACKGROUND
  Radiofrequency ablation (RFA) is undertaken as a potentially curative treatment for a variety of heart rhythm disturbances. Previous studies have demonstrated improved quality of life and reduced symptoms after ablation. In many health care environments waiting lists exist for scheduling of procedures. However, the psychological effects of waiting for radiofrequency ablation have not previously been assessed. We hypothesized that waiting for this intervention may be associated with increased psychological morbidity and health care costs.
  
  
  METHODS
  Ninety-two patients scheduled for elective RFA completed repeated questionnaires comprising the Medical Outcomes Short Form 36, Hospital Anxiety and Depression Scale, and an in-house questionnaire designed to assess the burden of symptoms related to arrhythmia (arrhythmia-related burden score). Mean scores were generated and compared at time points while waiting, before and after the procedure. Regression analyses were carried out to identify predictors of increased psychological morbidity while waiting and immediately prior to the procedure. Health care costs during the waiting period as a consequence of arrhythmia were quantified.
  
  
  RESULTS
  Mean scores for parameters of psychological morbidity worsened during the period of waiting and improved after the procedure. Predictors of adverse effects within the cohort varied according to the time point assessed for each of the measures of psychological morbidity. A conservative estimate of the health care cost incurred while waiting exceeds £ 181 per patient.
  
  
  CONCLUSIONS
  Waiting for radiofrequency ablation appears to be associated with adverse psychological effects and health care costs. These results may support strategies to reduce waiting times and prioritize resource allocation.
authors: Department of Cardiology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, UK. justin.barclay@nhs.net
authors: Justin L
authors: JL
authors: Barclay
authors: Patrick H
authors: PH
authors: Gibson
authors: Adele
authors: A
authors: Lewis
authors: Clare
authors: C
authors: Wilson
authors: Jonathan T
authors: JT
authors: Affolter
authors: Jitendra C
authors: JC
authors: Patel
authors: Neil W
authors: NW
authors: Scott
authors: David A
authors: DA
authors: Alexander
authors: Anna Maria
authors: AM
authors: Choy
authors: Paul A
authors: PA
authors: Broadhurst
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000191:economics* / Q000523:psychology* / Q000601:surgery; D017115:Catheter Ablation / Q000191:economics* / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000191:economics* / Q000523:psychology*; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D014850:Waiting Lists; D055815:Young Adult