Presentation (CTI)

OBJECTIVES: Atrial fibrillation (AF) patients suffer from irregular and often rapid heart rhythms, with catheter ablation serving as an important intervention for achieving sinus rhythm control. However, the clinical and economic outcomes of post-ablation AF patients in Japan are still poorly understood. This study aims to describe the clinical outcomes, direct medical costs, and healthcare resource utilisation (HCRU) in post-ablation AF patients in Japan in the real-world setting.
METHODS: This study followed a retrospective cohort design, including all eligible AF patients receiving catheter ablation as recorded in the Medical Data Vision (MDV) database. The index period for identifying ablation procedures was from January 2012 to August 2021. Each patient was followed from the date of the first ablation until their last medical record in the database or the end of data availability, whichever came first. Results were summarised using descriptive statistics. Wilcoxon rank-sum test was used to compare HCRU and medical costs between patients with and without complications.
RESULTS: A total of 20,306 patients were included in the analysis. The estimated incidence rate of repeated ablation was 0.075 per person-year. Overall, 2.0% of patients experienced at least one complication after the index ablation. The median annual direct medical cost was ¥1.53 million in total. Patients experiencing at least one complication had a significantly longer median length of index hospitalisation compared to those without complications (14.0 days vs 4.0 days, P<0.0001), and also incurred significantly higher median annual direct medical costs (¥2.08 million vs ¥1.52 million, P<0.0001).
CONCLUSIONS: This study highlights the opportunities for novel ablation technologies with enhanced safety profiles to achieve better economic outcomes and reduce HCRU and medical costs. It also offers essential data for future value assessment of ablation technologies in the Japanese context.