Catheter Ablation for AFib May Have Benefits, Cost Savings for Heart Failure Patients

Ablation for atrial fibrillation (AFib) may have some benefits for patients with heart failure (HF) as well, a new analysis suggests.

“Patients with HF undergoing AFib catheter ablation appear to derive improvements in quality of life and mortality compared to those treated with medical therapy (MT),” the authors wrote. “Contemporary national data on 30‐day readmissions after catheter ablation compared to MT among patients with HF are lacking.”

The study included data from the National Readmissions Database, with data on 749,776 patients with HF identified. Of those, 2,204 underwent ablation and 747,572 received medical therapy. The authors propensity-matched patients to balance baseline clinical characteristics, and compared 30-day readmission rates, causes, predictors, and costs of 30-day readmissions.

According to the results, 30-day readmissions were lower for patients treated with catheter ablation in both unmatched and matched cohorts (16.8% vs. 20.1%, P<0.001) compared to those receiving medical therapy (16.8% vs. 18.8%, P=0.020). The authors reported that ablation was associated with a reduction in the risk for readmission compared to medical therapy (OR=0.86; 95% CI, 0.77 to 0.97). Among the most common causes for readmission were HF exacerbation and arrhythmias. Although ablation costs were higher during index hospitalization, they were similar to medical therapy during readmission in the matched cohort (P=0.67). Non-modifiable risk factors in both groups were predictors of readmissions.

“Nearly one in six patients with HF are readmitted within 30‐days after undergoing catheter ablation,” the authors concluded. “In propensity matched analyses, ablation was associated with decreased rate and risk for readmission compared to medical therapy. Catheter ablation has higher index hospitalization costs, but lower readmission costs.”

The study was published in Pacing and Clinical Electrophysiology.