Healthcare utilization and costs associated with a diagnosis of incident atrial fibrillation

Deshmukh, Abhishek; Iglesias, Maximiliano; Khanna, Rahul; Beaulieu, Tara

doi:10.1016/j.hroo.2022.07.010

Cited by 41 publications

(14 citation statements)

References 34 publications

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“…2 Using US data from Optum (an administrative claims database for commercially insured [United Healthcare] patients in the United States), compared with patients without AF, patients with incident AF had an increased risk of inpatient visits and more cardiovascular-related emergency department visits (relative risk [RR], 2.41 [95% CI, 2.35–2.47]). 5 AF is costly. Examining Optum data, individuals with AF have annual health care costs of $63 031, which is $27 896 more than individuals without AF.…”

Section: Background and Pathophysiologymentioning

confidence: 99%

“…Examining Optum data, individuals with AF have annual health care costs of $63 031, which is $27 896 more than individuals without AF. 5 Investigators examining public and private health insurer data estimated that in US dollars in 2016, AF accounted for $28.4 billion (95% CI, $24.6 billion–$33.8 billion) in health care spending. 6…”

Section: Background and Pathophysiologymentioning

confidence: 99%

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2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Joglar,

Chung,

Armbruster

et al. 2024

Circulation

566

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AIM The “2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation” provides recommendations to guide clinicians in the treatment of patients with atrial fibrillation. METHODS A comprehensive literature search was conducted from May 12, 2022, to November 3, 2022, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, the Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline. Additional relevant studies, published through November 2022, during the guideline writing process, were also considered by the writing committee and added to the evidence tables, where appropriate. STRUCTURE Atrial fibrillation is the most sustained common arrhythmia, and its incidence and prevalence are increasing in the United States and globally. Recommendations from the “2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation” and the “2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation” have been updated with new evidence to guide clinicians. In addition, new recommendations addressing atrial fibrillation and thromboembolic risk assessment, anticoagulation, left atrial appendage occlusion, atrial fibrillation catheter or surgical ablation, and risk factor modification and atrial fibrillation prevention have been developed.

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Section: Background and Pathophysiologymentioning

confidence: 99%

Section: Background and Pathophysiologymentioning

confidence: 99%

2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Joglar,

Chung,

Armbruster

et al. 2024

Circulation

566

View full text Add to dashboard Cite

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“…The authors extrapolated to 2010 AF prevalence with an estimated national cost burden in the United States between 6 and 26 billion dollars (8). A more recent study, focused on incident AF, primarily in commercially insured patients, suggests the incremental cost burden, unstandardized and unadjusted for inflation, may be as much as three times higher (9). In contrast, the literature on the economic burden in patients diagnosed with AFL only is sparse.…”

Section: Introductionmentioning

confidence: 99%

Incremental healthcare cost burden in patients with atrial flutter only

Kim

Kim²,

Schulman³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundLimited information is available on the costs related to atrial flutter only. This study provides a comprehensive estimate of the cost in patients with atrial flutter only versus matched patients without any atrial arrhythmia.MethodsPatients over 20 years of age with a minimum of one inpatient or two outpatient diagnosis codes for atrial flutter in 2005 and a minimum of 12 months of continuous enrollment pre- and post-index were identified using the MarketScan Commercial and Medicare databases. Atrial flutter patients were propensity matched to patients without atrial arrhythmias. Total costs for each patient for 12 months post-index were calculated. National cost was estimated using the projected prevalence of atrial flutter for 2010.ResultsA total of 1,042 patients with atrial flutter only were successfully matched with comparison patients. For atrial flutter patients compared to matched controls without atrial arrhythmias, total mean annual cost per patient was 81% higher ($23,008 vs. $12,717) and mean annual inpatient expenditure was 214% higher ($8,518 vs. $2,713). When applied to national atrial flutter prevalence data, total incremental cost burden was estimated to be $687.9 million per year more than patients without atrial arrhythmias, primarily due to cardiovascular specific expenditure ($377 million, 55% of total) with 58% ($218.5 million) of the increased inpatient expenditure due to cardiovascular specific admissions and $159 million (23%) for atrial flutter specific care. Sex-related differences were also present in atrial flutter only patients.ConclusionAlthough atrial flutter-only patients are less prevalent than atrial fibrillation patients, the national incremental cost burden in atrial flutter is substantial on a per-patient level.

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“…1 AF diagnosis and treatment is associated with substantial financial cost, morbidity and mortality. [2][3][4][5][6] For these reasons, finding effective management strategies remains paramount.Over the decades, the management of AF has attempted to evolve to match the increasing understanding of the triggers for its initiation and perpetuation, with a heightened role of catheter-based ablative strategies. [7][8][9] While traditional focus has been on pulmonary vein isolation (PVI), more recent advanced approaches, including isolation of the posterior wall of the left atrium, ablation of the vein of Marshall (VoM), superior vena cava isolation, left atrial appendage isolation, rotor mapping and ablation, non-PV trigger ablation, scar homogenisation and other strategies, have been explored to limit recurrence in those with persistent forms of AF but with only incremental additional effectiveness compared with PVI alone in clinical studies.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Ganglionic Plexus Ablation: A Step-by-step Guide for Electrophysiologists and Review of Modalities for Neuromodulation for the Management of Atrial Fibrillation

Aksu

Skeete

Huang

2023

Arrhythm Electrophysiol Rev

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As the most common sustained arrhythmia, AF is a complex clinical entity which remains a difficult condition to durably treat in the majority of patients. Over the past few decades, the management of AF has focused mainly on pulmonary vein triggers for its initiation and perpetuation. It is well known that the autonomic nervous system (ANS) has a significant role in the milieu predisposing to the triggers, perpetuators and substrate for AF. Neuromodulation of ANS – ganglionated plexus ablation, vein of Marshall ethanol infusion, transcutaneous tragal stimulation, renal nerve denervation, stellate ganglion block and baroreceptor stimulation – constitute an emerging therapeutic approach for AF. The purpose of this review is to summarise and critically appraise the currently available evidence for neuromodulation modalities in AF.

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Healthcare utilization and costs associated with a diagnosis of incident atrial fibrillation

Cited by 41 publications

References 34 publications

2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Incremental healthcare cost burden in patients with atrial flutter only

Ganglionic Plexus Ablation: A Step-by-step Guide for Electrophysiologists and Review of Modalities for Neuromodulation for the Management of Atrial Fibrillation

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