Key result
Catheter ablation is linked to ~40% lower healthcare utilization at 12 months vs pre-ablation.
Why the study?
Little is known about the impact of catheter ablation using the ThermoCool SmartTouch SF catheter on health care utilization among patients with persistent atrial fibrillation.
Cohort (n=3,077)
Yes
Effect estimate: Absolute difference in proportions -24.4% (95% CI -26.9 to -22.0)
Absolute Event Rate: 36.4% vs 60.8%
Absolute Risk Reduction: 24.4%
p-value: p=<0.0001
Supports ablation with this catheter to potentially lower utilization in persistent AF; extends observational data but remains hypothesis-generating.
Background Catheter ablation (CA) is an effective treatment for patients with persistent atrial fibrillation (PsAF); however, little is known about its impact on health care utilization for patients with PsAF. The ThermoCool SmartTouch SF (STSF) catheter (Biosense Webster) incorporates an advanced porous tip and contact force–sensing technology. Objective The purpose of this study was to determine health care utilization among patients with PsAF who underwent ablation with the STSF catheter. Methods A retrospective cohort study using the Premier Healthcare Database identified patients with PsAF undergoing CA with the STSF catheter in inpatient and outpatient settings. The proportion of patients experiencing AF-related inpatient admissions, outpatient admissions, emergency department (ED) visits, electrical cardioversion, and a composite outcome in the 12 months pre- vs postablation were compared using the McNemar test. Subanalyses were performed on study outcomes by race/ethnicity. Results The final sample included 3077 patients (mean age 65.9 years; 31.7% female). Among patients with PsAF undergoing ablation with the STSF catheter, relative reductions in health care utilization in the 12 months post- vs preablation included 55.3% in AF-related inpatient admissions ( P <.0001), 38.9% in outpatient admissions ( P <.0001), 52.4% in ED visits ( P <.0001), and 61.2% in electrical cardioversions ( P <.0001). Composite outcome utilization in the 12 months post- vs preablation declined by 40.2% ( P <.0001) for the overall cohort, 40.0% for White patients ( P <.0001), 52.2% for Black patients ( P <.0001), and 50.1% for Asian patients ( P = .032). Conclusion Significant improvements in health care utilization were observed among PsAF patients who underwent ablation using the STSF catheter. Improvements were particularly marked in underrepresented racial and ethnic groups.
No takes yet. Share an insight, caveat, or question.
Doshi et al. (2022) conducted a cohort in Persistent atrial fibrillation (PsAF) (n=3,077). ThermoCool SmartTouch SF (STSF) catheter ablation vs. 12-month pre-ablation period was evaluated on Composite health care utilization (AF-related inpatient admissions, outpatient admissions, ED visits, and electrical cardioversion) (Absolute difference in proportions -24.4%, 95% CI -26.9 to -22.0, p=<0.0001). Catheter ablation using the ThermoCool SmartTouch SF catheter significantly reduced composite health care utilization by 40.2% in the 12 months post-ablation compared to pre-ablation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: