Healthcare utilization and clinical outcomes after ablation of atrial fibrillation in patients with and without insertable cardiac monitoring

Mansour, Moussa; Gillen, Emily M.; Garman, Audrey; Rosemas, Sarah; Franco, Noreli; Ziegler, Paul; Pines, Jesse M.

doi:10.1016/j.hroo.2021.12.005

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…The average cost of an AF hospitalization is determined to be $21 906. 6 Applying this information to our raw data for AF readmissions 1 year before ablation (0.47 per patient) versus AF readmissions 1 year after ablation (0.15 per patient), the net savings would be $6847 per patient per year. Similarly, considering 1 ED visit costs ≈$4100.80, the cost savings for our cohort would be $1231 per patient per year.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Hospitalizations and Resource Use Following Atrial Fibrillation Ablation

Dhande,

Barakat,

Canterbury

et al. 2023

JAHA

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Background Over the next few years, atrial fibrillation (AF)–related morbidity and costs will increase significantly. Thus, it is prudent to examine the impact of AF treatment on health care resource use. This study examined the impact of AF ablation on hospitalization, length of stay, and resource use for patients undergoing AF ablation in a multihospital system. Methods and Results In an observational analysis, outcomes of total, cardiovascular, and AF hospitalizations, emergency department visits, and length of stay were compared for 3417 patients between 12 months before and 24 months following AF ablation. Use of electrical cardioversions and antiarrhythmic use were also compared 1 year before to 2 years after AF ablation. There were fewer total (0.7±1.3 versus 0.3±0.7; P <0.001), cardiovascular (0.7±1.2 versus 0.2±0.6; P <0.001), and AF (0.6±1.1 versus 0.1±0.3; P <0.001) hospitalizations and emergency department visits (0.8±2.1 versus 0.4±0.9; P <0.001) per patient‐year for the 2 years following AF ablation compared with 1 year before. Average length of stay per patient‐year (1.4±7.9 versus 3.6±5.3 days; P <0.0001), the percentage of patients on antiarrhythmic therapy (21.2% versus 58.5%; P <0.0001), and those undergoing electrical cardioversions (16.1% versus 28.1%; P <0.0001) were lower 2 years following AF ablation versus 1 year before. Conclusions We noted a decrease in total, cardiovascular, and AF hospitalizations and health care resource use during the 2‐year period after index AF ablation, compared with the 1 year before. AF ablation may portend a decline in patient morbidity and health care costs.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular Hospitalizations and Resource Use Following Atrial Fibrillation Ablation

Dhande,

Barakat,

Canterbury

et al. 2023

JAHA

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Use of continuous cardiac monitoring to assess the influence of atrial fibrillation burden and patterns on patient symptoms and healthcare utilization: The DEFINE AFib study

Lakkireddy,

Russo,

Hylek

et al. 2024

Heart Rhythm O2

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Effectiveness, utilisation and cost associated with implantable loop recorders versus external monitors after ischaemic or cryptogenic stroke

Dhruva,

Murillo,

Ameli

et al. 2024

Open Heart

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ObjectiveImplantable loop recorders (ILRs) are increasingly used for long-term rhythm monitoring after ischaemic and cryptogenic stroke, with the goal of detecting atrial fibrillation (AF) and subsequent initiation of oral anticoagulation to reduce risk of adverse clinical outcomes. There is a need to determine the effectiveness of different rhythm monitoring strategies in this context.MethodsWe conducted a retrospective cohort analysis of individuals with commercial and Medicare Advantage insurance in Optum Labs Data Warehouse who had incident ischaemic or cryptogenic stroke and no prior cardiovascular implantable electronic device from 1 January 2016 to 30 June 2021. Patients were stratified by rhythm monitoring strategy: ILR, long-term continuous external cardiac monitor (>48 hours to 30 days) or Holter monitor (≤48 hours). The primary outcome was risk-adjusted all-cause mortality at 12 months. Secondary outcomes included new diagnosis of AF and oral anticoagulation, bleeding, and costs.ResultsAmong 48 901 patients with ischaemic or cryptogenic stroke, 9235 received an ILR, 29 103 long-term continuous external monitor and 10 563 Holter monitor only. Mean age was 69.9 (SD 11.9) years and 53.5% were female. During the 12-month follow-up period, patients who received ILRs compared with those who received long-term continuous external monitors had a higher odds of new diagnosis of AF and oral anticoagulant initiation (adjusted OR 2.27, 95% CI 2.09 to 2.48). Compared with patients who received long-term continuous external monitors, those who received ILRs had similar 12-month mortality (HR 1.00; 95% CI 0.89 to 1.12), with approximately $13 000 higher costs at baseline (including monitor cost) and $2500 higher costs during 12-month follow-up.ConclusionsIn this large real-world study of patients with ischaemic or cryptogenic stroke, ILR placement resulted in more diagnosis of AF and initiation of oral anticoagulation, but no difference in mortality compared with long-term continuous external monitors.

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Healthcare utilization and clinical outcomes after ablation of atrial fibrillation in patients with and without insertable cardiac monitoring

Cited by 3 publications

References 31 publications

Cardiovascular Hospitalizations and Resource Use Following Atrial Fibrillation Ablation

Cardiovascular Hospitalizations and Resource Use Following Atrial Fibrillation Ablation

Use of continuous cardiac monitoring to assess the influence of atrial fibrillation burden and patterns on patient symptoms and healthcare utilization: The DEFINE AFib study

Effectiveness, utilisation and cost associated with implantable loop recorders versus external monitors after ischaemic or cryptogenic stroke

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