Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Sep;6(9):1267-73.
doi: 10.1016/j.hrthm.2009.06.009. Epub 2009 Jun 6.

Trends in utilization and complications of catheter ablation for atrial fibrillation in Medicare beneficiaries

Ethan R Ellis  1 , Steven D Culler, April W Simon, Matthew R Reynolds
Affiliations

Trends in utilization and complications of catheter ablation for atrial fibrillation in Medicare beneficiaries

Ethan R Ellis et al. Heart Rhythm. 2009 Sep.

Abstract

Background: Utilization of radiofrequency catheter ablation (RFA) for treatment of atrial fibrillation (AF) is increasing. Data regarding the safety of RFA for AF outside of selected centers of excellence and in older patients are limited.

Objective: The purpose of this study was to quantify utilization of RFA for treatment of AF and rates of adverse events over time in unselected U.S. Medicare patients.

Methods: Using Medicare Provider Analysis and Review (MedPAR) files for fiscal years 2001-2006, we developed a coding algorithm to identify AF patients treated with RFA. The number of hospitals performing the procedure, the number of procedures performed, and the frequency of eight RFA complications were determined. The impact of patient characteristics on complication rates was assessed using multivariable logistic regression.

Results: For fiscal years 2001 to 2006, the number of hospitals performing RFA for AF in Medicare patients increased from 100 to 162, and the annual total procedure volume increased from 315 to 1975 cases. The overall complication rate was 9.1%. Annual complication rates increased from 6.7% in 2001 to 10.1% in 2006 (P for trend = .01), mainly due to an increase in rates of vascular access complications. Increasing patient age was not associated with a higher complication rate. Hospital procedural volume was not associated with the overall risk of complications but was associated with the probability of in-hospital death.

Conclusion: For fiscal years 2001-2006, use of RFA for treatment of AF increased markedly in the Medicare population. Overall complication rates rose during this time, with perforation/tamponade and vascular access complications accounting for the majority of events.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow diagram showing selection of study participants from Medicare Provider Analysis and Review (MedPAR) files for fiscal years 2001–2006 and main exclusion criteria. AF = atrial fibrillation; ICD = implantable cardioverter-defibrillator; RFA = radiofrequency ablation.
See this image and copyright information in PMC

Comment in

  • The imperative of a Medicare AF database.
    Schwartzman D. Schwartzman D. Heart Rhythm. 2009 Sep;6(9):1274-5. doi: 10.1016/j.hrthm.2009.06.021. Epub 2009 Jun 17. Heart Rhythm. 2009. PMID: 19656732 No abstract available.

References

    1. Miyasaka Y, Barnes ME, Gersh BJ, et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006;114:119–125. - PubMed
    1. Spragg DD, Dalal D, Cheema A, et al. Complications of catheter ablation for atrial fibrillation: incidence and predictors. J Cardiovasc Electrophysiol. 2008;19:627–631. - PubMed
    1. Cheema A, Vasamreddy CR, Dalal D, et al. Long-term single procedure efficacy of catheter ablation of atrial fibrillation. J Interv Card Electrophysiol. 2006;15:145–155. - PubMed
    1. Oral H, Pappone C, Chugh A, et al. Circumferential pulmonary-vein ablation for chronic atrial fibrillation. N Engl J Med. 2006;354:934–941. - PubMed
    1. Ouyang F, Ernst S, Chun J, et al. Electrophysiological findings during ablation of persistent atrial fibrillation with electroanatomic mapping and double Lasso catheter technique. Circulation. 2005;112:3038–3048. - PubMed