Health Care Utilization After Ventricular Tachycardia Ablation: A Propensity Score-Matched Cohort Study
| Autor: | Douglas S. Lee, Vijay S. Chauhan, Eugene Downar, Peter C. Austin, Diego Chemello, Andrew C.T. Ha, Kumaraswamy Nanthakumar, Xuesong Wang, Atif Al-Qubbany, Fahad Almehmadi, Andreu Porta-Sánchez, Hadas D. Fischer |
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| Rok vydání: | 2018 |
| Předmět: |
Tachycardia
Male medicine.medical_specialty Heart disease medicine.medical_treatment Catheter ablation 030204 cardiovascular system & hematology Rate ratio Ventricular tachycardia 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine Propensity Score Aged Retrospective Studies business.industry Hazard ratio Retrospective cohort study Middle Aged Patient Acceptance of Health Care Ablation medicine.disease 3. Good health Defibrillators Implantable Cardiology Catheter Ablation Costs and Cost Analysis Tachycardia Ventricular Female medicine.symptom Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents |
| Zdroj: | The Canadian journal of cardiology. 35(2) |
| ISSN: | 1916-7075 |
| Popis: | Background Catheter ablation of ventricular tachycardia (VT) can reduce the burden of ventricular arrhythmia (VA) but its effect on health care utilization and costs after such therapy is poorly known. We sought to compare the rates of cardiovascular (CV)-related hospitalizations, survival, and health care costs in patients with recurrent VT treated either with VT ablation or with medical therapy. Methods One-hundred implantable cardioverter-defibrillator patients with structural heart disease who underwent VT ablation were included. Propensity score-matched patients with recurrent VT treated with medical therapy were identified from a prospective registry of approximately 7000 de novo implantable cardioverter-defibrillator patients. Outcomes and costs were ascertained using health administrative databases. Results Among patients who underwent VT ablation, the cumulative rates of VA-related hospitalizations were lower in the 2 years after their ablation procedure compared with the year before (rate ratio, 0.3; 95% confidence interval [CI], 0.22-0.43). Rates of CV-related hospitalization and hospitalization because of VA post index date were similar between the VT ablation and medical therapy groups (hazard ratio [HR], 0.94; 95% CI, 0.57-1.54 and HR, 1.04; 95% CI, 0.57-1.91, respectively). Health care costs in the VT ablation patients were not increased post-ablation compared with the medical management group. The risk of all-cause mortality was lower among patients in the VT ablation group relative to the medical therapy group (HR, 0.64; 95% CI, 0.4-0.99). Conclusions Patients who underwent VT ablation experienced a significant reduction in their rate of VA-related hospitalizations. Patients treated with VT ablation had similar rates of CV-related hospitalization compared with those treated with medical therapy without increased health care-related costs. |
| Databáze: | OpenAIRE |
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