Healthcare utilization and clinical outcomes after catheter ablation of atrial flutter
Open accessAbstract
Atrial flutter ablation is associated with a high rate of acute procedural success and symptom improvement. The relationship between ablation and other clinical outcomes has been limited to small studies primarily conducted at academic centers. 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. California Healthcare Cost and Utilization Project databases were used to identify patients undergoing atrial flutter ablation between 2005 and 2009. The adjusted association between atrial flutter ablation and healthcare utilization, atrial fibrillation, or stroke was investigated using Cox proportional hazards models. 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. 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). 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). Risk of acute stroke was not significantly reduced after ablation (HR 1.09, 95% CI 0.81-1.45, p = 0.57). 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. These findings support the early use of catheter ablation for the treatment of atrial flutter.
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Isthmus ablation may also reduce AF recurrences in selected patients and help to prevent hospitalizations.
“It may also reduce AF recurrences in selected patients, 1003,1004 and help to prevent hospitalizations.1004,1005”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [1005]
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References 17 · Cited by 32
- Authors
- Dewland, T. A., Glidden, D. V., & Marcus, G. M.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Marcus, Gregory M.
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-07-01
- Volume
- 9
- Issue
- 7
- Pages
- e100509
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4077565
- OpenAlex
- W2004685022
- Cited by
- 32
- References
- 17
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2021: 6 · 2020: 2 · 2019: 3 · 2017: 2 · 2016: 5 · 2015: 7
- FWCI
- 3.20
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- American Heart Association (12POST11810036, 12GRNT11780061)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- atrial flutter, catheter ablation, health care utilization, hospitalization, emergency department visits, atrial fibrillation, stroke, clinical outcomes, real-world evidence
- MeSH terms
- Aged, Aged, 80 and over, Atrial Flutter, Costs and Cost Analysis, Delivery of Health Care, Female, Humans, Male, Middle Aged, San Francisco, Catheter Ablation
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