Evaluation of the Impact of Catheter Ablation Procedure on Outcomes and Economic Burden in Patients with Atrial Fibrillation: Real-World Data from Italian Administrative Databases

Abstract: A real-world analysis among the Italian population has been carried out to estimate the
number of atrial fibrillation (AF) patients undergoing catheter ablation and to evaluate their clinical
outcome and economic burden. A retrospective analysis on administrative Italian databases has
been performed. Between January 2011 and December 2019, all patients diagnosed with AF were
considered and those undergoing catheter ablation were identified. Overall, 3084 (3.54%) of AF
patients with at least one catheter ablation were included (mean age 63.2, 67.3% males). A significant
decrease in the use of AF-related medications and in hospitalizations, mainly related to AF and heart
failure, was observed during the 3-year post-ablation period. The average total cost per patient during
the 1-year before ablation period was significantly higher compared to the 1-year post-ablation cost
(EUR 5248 vs. 4008, respectively; p < 0.001). After propensity score matching, the overall mortality
of patients who underwent ablation was significantly lower compared to that assessed in patients
not treated with the procedure (9.386/1000 vs. 23.032/1000 person-year, respectively; p < 0.001).
Moreover, the mean total costs were significantly higher in patients who did not undergo ablation
compared to those who received ablation (EUR 5516 vs. 4008, respectively; p < 0.001). This real-world
data analysis shows that in Italy, although catheter ablation is performed in a minority of AF patients,
it is associated with significantly better post-procedure clinical outcomes and a significant reduction
in healthcare-related costs.