OBJECTIVES

To compare economic outcomes among patients with atrial fibrillation (AF) undergoing ablation using newer generation radiofrequency (RF) THERMOCOOL SMARTTOUCH^® SF Catheter with contact force (CF) and porous tip technology versus the CF standard irrigation THERMOCOOL SMARTTOUCH^® Catheter.

METHODS

Patients with a primary diagnosis of AF (≥18 years) who underwent index (first occurrence) RF ablation in an outpatient setting (09/01/2016–03/31/2018) were identified from the Premier Healthcare database. Using a text search strategy of hospital charge descriptors, catheter brands were identified. Propensity matching was used to match patients in the two groups on demographic, procedural, hospital, and comorbidity characteristics. Index ablation cost (including total cost, supply cost) and 4 to 6-month inpatient readmission (all-cause, cardiovascular [CV]-related, AF-related) rate and cost (inflation adjusted, US2017$) were compared between the two groups. Generalized estimating equation with log link and gamma distribution was used to compare cost among the matched cohort, adjusting for hospital clustering.

RESULTS

For index ablation cost comparison, 571 propensity matched patients were identified in both groups. No significant difference in total index ablation cost ($22,266vs$21,568;p=0.3701) and supply cost ($9,799vs$9,913;p=0.9074) was found between the THERMOCOOL SMARTTOUCH^® SF Catheter and THERMOCOOL SMARTTOUCH^® Catheter group. For 4 to 6-month inpatient readmission rate and cost comparison, 324 propensity matched patients were identified in both the groups. The 4-6 month all-cause (2.78%vs2.78%;p=1.000), CV-related (1.23%vs1.23%;p=1.000), and AF-related readmission (0.93%vs0.62%;p=0.6535) rates were similar among the two groups; however, the all-cause readmission cost ($205vs$831;p=0.0129) and CV-related readmission cost ($50vs$473;p=0.0021) were significantly lower for the THERMOCOOL SMARTTOUCH^® SF Catheter group versus the THERMOCOOL SMARTTOUCH^® Catheter group. There was no significant difference in AF-related readmission cost.

CONCLUSIONS

Though the readmission rate were similar among the two catheter groups, the use of THERMOCOOL SMARTTOUCH^® SF Catheter for AF ablation was associated with lower readmission cost versus the THERMOCOOL SMARTTOUCH^® Catheter.