What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Atrial fibrillation (n=124947000). Intervention: Catheter ablation. Primary outcome: Regional disparities in AF catheter ablation rates and associated factors.

What does this research mean for the field?

Regional atrial fibrillation ablation rates positively correlate with the number of local arrhythmia specialists and specific socioeconomic factors, which in turn is associated with reduced AF hospitalization rates. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 16, 2025Circulation Reports9 citationsOpen Access

Regional Disparities in Atrial Fibrillation Catheter Ablation Based on the Japanese National Survey

TKTakahiro KamiharaNational Center for Geriatrics and Gerontology SKShinji KanekoHiroshima University TOTakuya OmuraNational Center for Geriatrics and Gerontology

Key Result

In a nationwide analysis of 124,947,000 people, regional atrial fibrillation ablation rates positively correlated with the number of arrhythmia specialists and socioeconomic factors.

Study Design

Type

Cross-Sectional (n=124,947,000)

Multicenter

Yes

Structured PICO

Population

124,947,000 people in Japan (2022 national census data) analyzed at the prefectural level to assess atrial fibrillation hospitalizations and catheter ablation rates.

Outcome

Regional disparities in atrial fibrillation catheter ablation rates and hospitalizations, and their correlation with socioeconomic and climatic factors.

Socioeconomic factors and the availability of arrhythmia specialists significantly influence regional rates of atrial fibrillation hospitalizations and catheter ablations in Japan, despite a universal healthcare system.

Abstract

Background: The prevalence of atrial fibrillation (AF) has increased with aging populations, making catheter ablation essential. However, access to this treatment across regions, even with universal healthcare, is not well understood. This study aims to explore potential regional disparities in AF catheter ablation rates and identify associated factors. Methods and Results: This cross-sectional study analyzed data from the Vital Statistics survey of Japanese events in 2022 (124,947,000 people), the Japanese government Survey of Household Economy, the Survey on the Impact of the Diagnosis Procedure Combination System, and publicly available data from the Japan Heart Rhythm Society. Principal component regression analysis revealed that the number of AF hospitalizations exhibited a positive correlation with the prevalence of hypertension and the percentage of unemployed men. The number of ablations positively correlated with overtime hours, university graduate salaries, part-time employment rates, and the number of arrhythmia specialists. AF hospitalization rates exhibited a negative correlation with AF ablation rates. The number of arrhythmia specialists correlated positively with ablation rates but negatively with AF hospitalization rates. Conclusions: Socioeconomic factors appear to influence AF hospitalizations and treatment decisions. An increase in arrhythmia specialists may optimize ablation rates and reduce AF hospitalization rates.

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