Evidence map›Paper›PMID 33022815›Full record

ArticleJournal of cardiovascular electrophysiology2020

Healthcare utilization and cost in patients with atrial fibrillation and heart failure undergoing catheter ablation.

Michael E Field, Michael R Gold, Motiur Rahman, Laura Goldstein, Sonia Maccioni, Abhishek Srivastava, Rahul Khanna, Jonathan P Piccini, Daniel J Friedman

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cardiovascular electrophysiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.0field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 2 countries.

Michael E FieldDivision of Cardiology, Medical University of South Carolina, Charleston, South Carolina, USA.ORCID 0000-0003-0603-9670
Michael R GoldDivision of Cardiology, Medical University of South Carolina, Charleston, South Carolina, USA.ORCID 0000-0002-4579-0216
Motiur RahmanMedical Device Epidemiology, Johnson and Johnson, New Brunswick, New Jersey, USA.
Laura GoldsteinFranchise Health Economics and Market Access, Johnson & Johnson Medical Devices, Irvine, California, USA.
Sonia MaccioniBiosense Webster Inc., Irvine, California, USA.
Abhishek SrivastavaMu Sigma, Bangalore, India.
Rahul KhannaMedical Device Epidemiology, Johnson and Johnson, New Brunswick, New Jersey, USA.ORCID 0000-0002-2478-1724
Jonathan P PicciniDivision of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA.ORCID 0000-0003-0772-2404
Daniel J FriedmanDivision of Cardiology, Yale School of Medicine, New Haven, Connecticut, USA.
Johnson & Johnson (United States) · USMedical University of South Carolina · USClinical Research Institute · USSigma Engineering (Germany) · DEWebster University · USYale University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCatheter ablation is an effective treatment for patients with atrial fibrillation (AF) and heart failure (HF). However, little is known about how healthcare utilization and cost change after ablation in this population. We sought to determine healthcare utilization and cost patterns among patients with AF and HF undergoing ablation.

methodsUsing a large United States administrative database, we identified (n = 1568) treated with ablation with a primary and secondary diagnosis of AF and HF, respectively, were evaluated 1-year pre- and postablation for outcomes including inpatient admissions (AF or HF), emergency department (ED) visits, cardioversions, length of stay (LOS), and cost. A secondary analysis was extended to 3-years postablation.

resultsReductions were observed in AF-related admissions (64%), LOS (65%), cardioversions (52%), ED visits (51%, all values, p < .0001), and HF-related admissions (22%, p = .01). There was a 40% reduction in inpatient admission cost ($4165 preablation to $2510 postablation, p < .0001). In a sensitivity analysis excluding repeat-ablation patients, a greater reduction in overall AF management cost was observed compared to the full cohort (-43% vs. -2%). Comparing 1-year pre- to 3-years postablation, both total mean AF-management cost ($850 per-patient per-month 1-year pre- to $546 3-years postablation, p < .0001) and AF-related healthcare utilization was reduced.

conclusionsCatheter ablation in patients with AF and HF resulted in significant reductions in healthcare utilization and cost through 3-years of follow-up. This reduction was observed regardless of whether repeat ablation was performed, reflecting the positive impact of ablation on longer term cost reduction.

Indexed as

Atrial FibrillationCatheter AblationHeart FailureHumansPatient Acceptance of Health CareTreatment OutcomeUnited Statesatrial fibrillationcatheter ablationhealthcare economicshealth policyheart failure

Identifiers

PMID33022815
PMCPMC7821325
OpenAlexW3092363195

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.