Healthcare Utilization and Quality of Life Improvement after Ablation for Paroxysmal AF in Younger and Older Patients.
BACKGROUND
Atrial fibrillation (AF) prevalence increases significantly with age. Little is known about the effect of AF ablation on quality of life and healthcare utilization in the elderly. The objective of this study was to quantify the healthcare utilization and quality of life benefits of catheter ablation for AF, for patients ≥65 years compared to patients <65 years.


METHODS
Two multicenter U.S. registry studies enrolled patients with paroxysmal AF. Baseline characteristics and acute outcomes were collected for 736 patients receiving catheter ablation with the Navistar® ThermoCool® SF Catheter (Biosense Webster, Inc., Diamond Bar, CA, USA). Healthcare utilization and quality of life outcomes were collected through 1 year postablation for 508 patients.


RESULTS
The rates of acute pulmonary vein isolation were high and similar between patients ≥65 years and <65 years (97.5% vs 95.8%, P = 0.2130). Length of stay for the index procedure was similar between age groups with 82.2% of the older group and 83.2% of the younger group having one-day hospitalization. Disease-specific quality of life instrument scores improved significantly and similarly for older and younger patients at 1 year postablation, compared to baseline. AF-related hospitalizations and emergency department visits were similar or lower in older patients compared to younger patients, as reported at 1 year postablation.


CONCLUSIONS
For older patients undergoing catheter ablation for paroxysmal AF, healthcare utilization parameters were lower or not significantly different than for younger patients, and quality of life outcomes were similarly improved. These findings support the use of catheter ablation as a treatment option in older patients with paroxysmal AF.
New York Presbyterian Hospital, Columbia University Medical Center, Department of Medicine, Cardiology Division, Columbia University College of Physicians and Surgeons, New York, New York.
Angelo B
AB
Biviano
Health Economics Outcomes Research, CTI Clinical Trial and Consulting Services, Inc., Cincinnati, Ohio.
Tina D
TD
Hunter
Indiana University School of Medicine, Indianapolis, Indiana.
Gopi
G
Dandamudi
Florida Electrophysiology Associates, West Palm Beach, Florida.
Robert S
RS
Fishel
Cardiology, Heart Rhythm Center, Santa Barbara, California.
Brett
B
Gidney
Electrophysiology and Arrhythmia Services, Department of Cardiovascular Disease, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, Florida.
Bengt
B
Herweg
The Atrial Fibrillation Institute, St. Vincent's Medical Center, Jacksonville, Florida.
Saumil R
SR
Oza
St. Joseph's Hospital of Atlanta/Emory University, Atlanta, Georgia.
Anshul Mahendra
AM
Patel
Florida Hospital Memorial Medical Center, Daytona Beach, Florida.
Huijian
H
Wang
Arrhythmia and Ablation Center, Florida Hospital, Orlando, Florida.
Scott J
SJ
Pollak
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery*; D017115:Catheter Ablation / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D017678:Sex Distribution; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014600:Utilization Review; D055815:Young Adult
Medicare; atrial fibrillation; catheter ablation; elderly; healthcare utilization; quality of life