Real-world outcomes comparison among adults with atrial fibrillation undergoing catheter ablation with a contact force porous tip catheter versus a second-generation cryoballoon catheter: a retrospective analysis of multihospital US database
Objective To compare real-world clinical and economic outcomes among atrial fibrillation (AF) patients undergoing cardiac ablation with the contact force-sensing porous tip THERMOCOOL SMARTTOUCH SF (STSF) catheter versus the Arctic Front Advance Cryoballoon (AFA-CB) catheter.Design Retrospective, ob...
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ftdoajarticles:oai:doaj.org/article:43cdbbbdac524839b22265299580ae11 2023-05-15T15:17:16+02:00 Real-world outcomes comparison among adults with atrial fibrillation undergoing catheter ablation with a contact force porous tip catheter versus a second-generation cryoballoon catheter: a retrospective analysis of multihospital US database Iftekhar Kalsekar Rahul Khanna Alexandru Costea Laura Goldstein Sonia Maccioni 2020-08-01T00:00:00Z https://doi.org/10.1136/bmjopen-2019-035499 https://doaj.org/article/43cdbbbdac524839b22265299580ae11 EN eng BMJ Publishing Group https://bmjopen.bmj.com/content/10/8/e035499.full https://doaj.org/toc/2044-6055 doi:10.1136/bmjopen-2019-035499 2044-6055 https://doaj.org/article/43cdbbbdac524839b22265299580ae11 BMJ Open, Vol 10, Iss 8 (2020) Medicine R article 2020 ftdoajarticles https://doi.org/10.1136/bmjopen-2019-035499 2022-12-31T10:47:09Z Objective To compare real-world clinical and economic outcomes among atrial fibrillation (AF) patients undergoing cardiac ablation with the contact force-sensing porous tip THERMOCOOL SMARTTOUCH SF (STSF) catheter versus the Arctic Front Advance Cryoballoon (AFA-CB) catheter.Design Retrospective, observational cohort study.Setting Premier Healthcare Database (PHD), between 1 September 2016 and 30 June 2018.Participants Patients with AF (≥18 years) were included if they had an index ablation procedure performed using the STSF catheter or AFA-CB catheter at a US hospital that consistently provided inpatient and outpatient data to PHD in the 12-month preindex period. Using 1:1 propensity score matching, patient groups were matched on study covariates.Primary and secondary outcome measures Cost, length of stay (LOS), readmissions, direct current cardioversion (DCCV) and reablation outcomes were compared between matched cohorts of STSF and AFA-CB patients.Results A total of 3015 patients with AF met the study criteria, of which 1720 had ablation using the STSF catheter and 1295 had ablation using the AFA-CB catheter. In the propensity-matched sample, patients receiving ablation with the STSF catheter had ~17% lower total costs (US$23 096 vs US$27 682, p≤0.0001) and ~27% lower supply costs (US$10 208 vs US$13 816, p≤0.0001) versus patients receiving ablation with the AFA-CB catheter. A significantly lower likelihood of 4-month to 6-month cardiovascular-related readmission (OR 0.460, 95% CI 0.220 to 0.959) was associated with the STSF catheter versus the AFA-CB catheter. No significant differences in LOS, room and board cost, 4-month to 6-month all-cause and AF-related readmissions, DCCV and reablation were observed among technologies. Sensitivity analysis restricting patient sample by provider ablation volume demonstrated similar results.Conclusion Lower index ablation total and supply costs were observed among patients with AF undergoing cardiac catheter ablation using the STSF catheter versus the AFA-CB catheter. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic BMJ Open 10 8 e035499 |
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Directory of Open Access Journals: DOAJ Articles |
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Medicine R |
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Medicine R Iftekhar Kalsekar Rahul Khanna Alexandru Costea Laura Goldstein Sonia Maccioni Real-world outcomes comparison among adults with atrial fibrillation undergoing catheter ablation with a contact force porous tip catheter versus a second-generation cryoballoon catheter: a retrospective analysis of multihospital US database |
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Medicine R |
description |
Objective To compare real-world clinical and economic outcomes among atrial fibrillation (AF) patients undergoing cardiac ablation with the contact force-sensing porous tip THERMOCOOL SMARTTOUCH SF (STSF) catheter versus the Arctic Front Advance Cryoballoon (AFA-CB) catheter.Design Retrospective, observational cohort study.Setting Premier Healthcare Database (PHD), between 1 September 2016 and 30 June 2018.Participants Patients with AF (≥18 years) were included if they had an index ablation procedure performed using the STSF catheter or AFA-CB catheter at a US hospital that consistently provided inpatient and outpatient data to PHD in the 12-month preindex period. Using 1:1 propensity score matching, patient groups were matched on study covariates.Primary and secondary outcome measures Cost, length of stay (LOS), readmissions, direct current cardioversion (DCCV) and reablation outcomes were compared between matched cohorts of STSF and AFA-CB patients.Results A total of 3015 patients with AF met the study criteria, of which 1720 had ablation using the STSF catheter and 1295 had ablation using the AFA-CB catheter. In the propensity-matched sample, patients receiving ablation with the STSF catheter had ~17% lower total costs (US$23 096 vs US$27 682, p≤0.0001) and ~27% lower supply costs (US$10 208 vs US$13 816, p≤0.0001) versus patients receiving ablation with the AFA-CB catheter. A significantly lower likelihood of 4-month to 6-month cardiovascular-related readmission (OR 0.460, 95% CI 0.220 to 0.959) was associated with the STSF catheter versus the AFA-CB catheter. No significant differences in LOS, room and board cost, 4-month to 6-month all-cause and AF-related readmissions, DCCV and reablation were observed among technologies. Sensitivity analysis restricting patient sample by provider ablation volume demonstrated similar results.Conclusion Lower index ablation total and supply costs were observed among patients with AF undergoing cardiac catheter ablation using the STSF catheter versus the AFA-CB catheter. |
format |
Article in Journal/Newspaper |
author |
Iftekhar Kalsekar Rahul Khanna Alexandru Costea Laura Goldstein Sonia Maccioni |
author_facet |
Iftekhar Kalsekar Rahul Khanna Alexandru Costea Laura Goldstein Sonia Maccioni |
author_sort |
Iftekhar Kalsekar |
title |
Real-world outcomes comparison among adults with atrial fibrillation undergoing catheter ablation with a contact force porous tip catheter versus a second-generation cryoballoon catheter: a retrospective analysis of multihospital US database |
title_short |
Real-world outcomes comparison among adults with atrial fibrillation undergoing catheter ablation with a contact force porous tip catheter versus a second-generation cryoballoon catheter: a retrospective analysis of multihospital US database |
title_full |
Real-world outcomes comparison among adults with atrial fibrillation undergoing catheter ablation with a contact force porous tip catheter versus a second-generation cryoballoon catheter: a retrospective analysis of multihospital US database |
title_fullStr |
Real-world outcomes comparison among adults with atrial fibrillation undergoing catheter ablation with a contact force porous tip catheter versus a second-generation cryoballoon catheter: a retrospective analysis of multihospital US database |
title_full_unstemmed |
Real-world outcomes comparison among adults with atrial fibrillation undergoing catheter ablation with a contact force porous tip catheter versus a second-generation cryoballoon catheter: a retrospective analysis of multihospital US database |
title_sort |
real-world outcomes comparison among adults with atrial fibrillation undergoing catheter ablation with a contact force porous tip catheter versus a second-generation cryoballoon catheter: a retrospective analysis of multihospital us database |
publisher |
BMJ Publishing Group |
publishDate |
2020 |
url |
https://doi.org/10.1136/bmjopen-2019-035499 https://doaj.org/article/43cdbbbdac524839b22265299580ae11 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
BMJ Open, Vol 10, Iss 8 (2020) |
op_relation |
https://bmjopen.bmj.com/content/10/8/e035499.full https://doaj.org/toc/2044-6055 doi:10.1136/bmjopen-2019-035499 2044-6055 https://doaj.org/article/43cdbbbdac524839b22265299580ae11 |
op_doi |
https://doi.org/10.1136/bmjopen-2019-035499 |
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BMJ Open |
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10 |
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8 |
container_start_page |
e035499 |
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