Racial and ethnic-minority groups and those with lower income are less likely to receive rhythm control treatment for atrial fibrillation (AF), according to a recent study published online in JAMA Network Open.
Lauren A. Eberly, MD, MPH, from the University of Pennsylvania in Philadelphia, and colleagues investigated the presence of inequities in AF management (rates of anti-arrhythmic drugs [AADs] and catheter ablation use) using inpatient, outpatient, and pharmacy claims data from the Optum Clinformatics Data Mart (109,221 patients; Oct. 1, 2015, to June 30, 2019).
The researchers found that 86,359 patients (79.1 percent) were treated with rate control, 19,362 patients (17.7 percent) with AADs, and 3,500 (3.2 percent) with catheter ablation. The cumulative percentage of patients treated with catheter ablation increased from 1.6 to 3.8 percent. There were independent associations between lower use of rhythm control and Black race (adjusted odds ratio [aOR], 0.89) and lower zip code-linked median household income (aOR for <$50,000, 0.83; aOR for $50,000 to $99,999, 0.92 [versus ≥$100,000]). Among those receiving rhythm control, there was an independent association observed between lower catheter ablation use and Latinx ethnicity (aOR, 0.73) and lower zip code-linked median household income (aOR for <$50,000, 0.61; aOR for $50,000 to $99,999, 0.81 [versus ≥$100,000]).
“As evidence builds regarding the benefits of early rhythm control and particularly catheter ablation, we must ensure that all our patients benefit equally,” a coauthor said in a statement.
One study author disclosed financial ties to a health care company.
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