We therefore used data from the Healthcare Cost and Utilization Project (HCUP) to determine if catheter ablation is associated with reductions in healthcare utilization, AF, and stroke among a contemporary population of California residents diagnosed with AFL. The relationship between AFL ablation and these important clinical outcomes has not been studied in a large, real world population. Finally, although AFL ablation could potentially reduce the risk of thromboembolic stroke through maintenance of sinus rhythm, prior investigations have not been powered to assess for differences in this endpoint. Furthermore, while one randomized trial demonstrated less atrial fibrillation (AF) after AFL ablation, this finding was not replicated in a second study. Although previous investigations have found an association between AFL ablation and a reduction in subsequent healthcare visits, these small studies have been limited to single academic centers, or to carefully selected randomized trial participants. The impact of AFL ablation on other arrhythmia related clinical outcomes, however, is less clear. In addition, randomized comparisons of ablation versus medical management have shown significantly less symptoms, reduced morbidity, and enhanced quality of life with an ablation strategy. AFL ablation is associated with a high rate of acute procedural success and a low incidence of AFL recurrence during follow up. The efficacy of endocardial catheter ablation for the treatment of atrial flutter (AFL) is well established. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.įunding: This work was made possible by grant numbers 12POST11810036 (TAD) and 12GRNT11780061 (GMM) from the American Heart Association, and by the Joseph Drown Foundation (GMM). Received: JanuAccepted: Published: July 1, 2014Ĭopyright: © 2014 Dewland et al. Sovari, University of Illinois at Chicago, United States of America These findings support the early use of catheter ablation for the treatment of atrial flutter.Ĭitation: Dewland TA, Glidden DV, Marcus GM (2014) Healthcare Utilization and Clinical Outcomes after Catheter Ablation of Atrial Flutter. In a large, real world population, atrial flutter ablation was associated with significant reductions in hospital-based healthcare utilization and a reduced risk of atrial fibrillation. Risk of acute stroke was not significantly reduced after ablation (HR 1.09, 95% CI 0.81–1.45, p = 0.57). Atrial flutter ablation was also associated with a statistically significant 11% reduction in the adjusted hazard of atrial fibrillation (HR 0.89, 95% CI 0.81–0.97, p = 0.01). Atrial flutter ablation significantly lowered the adjusted risk of inpatient hospitalization (HR 0.88, 95% CI 0.84–0.92, p<0.001), emergency department visits (HR 0.60, 95% CI 0.54–0.65, p<0.001), and overall hospital-based healthcare utilization (HR 0.94, 95% CI 0.90–0.98, p = 0.001). Among 33,004 patients with a diagnosis of atrial flutter observed for a median of 2.1 years, 2,733 (8.2%) underwent catheter ablation. The adjusted association between atrial flutter ablation and healthcare utilization, atrial fibrillation, or stroke was investigated using Cox proportional hazards models. California Healthcare Cost and Utilization Project databases were used to identify patients undergoing atrial flutter ablation between 20. We sought to determine if catheter ablation of atrial flutter is associated with reductions in healthcare utilization, atrial fibrillation, or stroke in a large, real world population. The relationship between ablation and other clinical outcomes has been limited to small studies primarily conducted at academic centers. Atrial flutter ablation is associated with a high rate of acute procedural success and symptom improvement.
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