OBJECTIVES : Catheter ablation for paroxysmal supraventricular tachycardia (PSVT) is potentially curative, but little is known about healthcare costs and resource utilization (HRU) following ablation. The goal of this study was to characterize HRU and costs in PSVT patients < 65 years treated with ablation.

METHODS : This retrospective study used demographic, enrollment, and claims data from the Truven Health MarketScan^® database to identify patients < 65 years with an initial catheter ablation for PSVT (ICD-9: 427.0; ICD-10: I47.1) between January 1, 2009 and December 31, 2015. Patients were observable for one year before and after index ablation. The primary outcomes were HRU, costs paid by insurers, repeat ablations and pacemaker implantations within one year of index.

RESULTS : Among 20,649 patients meeting study criteria, mean age was 44.1 years (SD: 15.6); 59.1% were female sex. Of these, 1,520 (7.4%) had a second ablation within 12 months, and 3.6% (N=748) had pacemaker implantation. Mean per patient costs in the follow-up year, $52,717, were significantly higher compared with pre-index ($18,662; P<0.0001), but showed no change when index ablation costs ($34,028) were excluded ($18,689 vs. $18,662). Repeat ablations and pacemaker implantations contributed to post-index costs per patient ($3,243 and $2,656, respectively). Inpatient admission rates increased (from 0.33 to 0.38 per patient), reflecting index and repeat ablations and pacemaker implantations (0.18, 0.02, 0.02, respectively). Emergency Department (ED) visit rates decreased significantly post-index (from 1.01 to 0.55; P<0.0001). The proportions of patients treated with calcium channel blocker (CCB) and beta-blockers also decreased (from 66.0% to 43.8%; P<0.0001).

CONCLUSIONS : Catheter ablation for PSVT is associated with significant cost increases. Costs net of ablations show no change relative to pre-ablation year costs. Repeat ablations and pacemaker implantation contribute to post-ablation costs and hospitalizations. ED visit and CCB/beta blocker use rates decrease.