@article{f8f7d98c7fd749e69d5ca63b45f5c59c,
title = "Economic impact of contact force sensing in catheter ablation for atrial fibrillation",
abstract = "Aims: The TactiCath Contact Force Ablation Catheter Study for Atrial Fibrillation (TOCCASTAR) clinical trial compared clinical outcomes using a contact force (CF) sensing ablation catheter (TactiCath) with a catheter that lacked CF measurement. This analysis links recorded events in the TOCCASTAR study and a large claims database, IBM MarketScan{\textregistered}, to determine the economic impact of using CF sensing during atrial fibrillation (AF) ablation. Methods and Results: Clinical events including repeat ablation, use of antiarrhythmic drugs, hospitalization, perforation, pericarditis, pneumothorax, pulmonary edema, pulmonary vein stenosis, tamponade, and vascular access complications were adjudicated in the year after ablation. CF was characterized as optimal if greater than or equal to 90% lesion was performed with greater than or equal to 10 g of CF. A probabilistic 1:1 linkage was created for subjects in MarketScan{\textregistered} with the same events in the year after ablation, and the cost was evaluated over 10 000 iterations. Of the 279 subjects in TOCCASTAR, 145 were ablated using CF (57% with optimal CF), and 134 were ablated without CF. In the MarketScan{\textregistered} cohort, 9811 subjects who underwent AF ablation were used to determine events and costs. For subjects ablated with optimal CF, total cost was $19 271 ± 3705 in the year after ablation. For ablation lacking CF measurement, cost was $22 673 ± 3079 (difference of $3402, P <.001). In 73% of simulations, optimal CF was associated with lower cost in the year after ablation. Conclusion: Compared to ablation without CF, there was a decrease in healthcare cost of $3402 per subject in the first year after the procedure when optimal CF was used.",
keywords = "MarketScan{\textregistered}, TOCCASTAR, atrial fibrillation, contact force, economics, radiofrequency ablation",
author = "Moussa Mansour and Reddy, {Vivek Y.} and Edward Karst and Heist, {Edwin Kevin} and Packer, {Douglas L.} and Nirav Dalal and Rahul Agarwal and Hugh Calkins and Ruskin, {Jeremy N.} and Srijoy Mahapatra",
note = "Funding Information: : M. Mansour is consultant for Abbott, Boston Scientific, Biosense‐Webster, Medtronic; has equity interests or stock options in NewPace and EPD Solutions; has research grants from Boehringer Ingelheim, Pfizer, Abbott, Biosense‐Webster, Boston Scientific, and Sentre Heart. V. Y. Reddy has received consulting income from Abbott, Biosense Webster, Axon, Biotronik, Boston Scientific, Cardiofocus, Cardionomics, CardioNXT/AFTx, EBR, Impulse Dynamics, Medtronic and Phillips; is consultant and has equity in Acutus Medical, Affera, Apama Medical, Aquaheart, Automix, Backbeat, BioSig, Circa Scientific, Corvia Medical, East End Medical, EPD, Epix Therapeutics, EpiEP, Eximo, Javelin, Keystone Heart, LuxCath, MedLumics, Middlepeak, Nuvera, Surecor, Valcare, and VytronUS; has equity in Manual Surgical Sciences and Newpace. E. Karst, N. Dalal, and R. Agarwal are employees of Abbott. E. K. Heist has received honoraria from Boston Scientific, Abbott, Johnson & Johnson, and Medtronic; has research grants from Boston Scientific and Abbott; is a consultant for Biotronik. D. L. Packer has served as a consultant for Abbott, Aperture Diagnostics, Biosense Webster, Biotronik, Boston Scientific, CardioFocus, Johnson & Johnson, MediaSphere Medical, Medtronic, Siemens, Spectrum Dynamics, and Thermedical; has received research funding from Abbott, Biosense Webster, Boston Scientific/EPT, CardioInsight, CardioFocus, Endosense, Hansen Medical, Medtronic, National Institutes of Health, Robertson Foundation, Siemens, and Thermedical; has received royalties from Abbott, Mayo Clinic, Oxford, and Wiley & Sons; has equity in External Beam Ablation Medical Devices. H. Calkins receives lecture honoraria and is a consultant for Boehringer Ingelheim, Medtronic, and Boston Scientific. J. N. Ruskin has served on scientific advisory board of Ablacor, Acesion Pharma, InfoBionic, LuxCath, and Medtronic; is a consultant for Advanced Medical Education, Cala Health, InCarda Therapeutics, Johnson & Johnson, and Portola Pharmaceuticals; has equity/founder in Celero Systems, Gilead Sciences, Portola Pharmaceuticals; on steering committee of Pfizer. S. Mahapatra is shareholder of Abbott. Disclosures Publisher Copyright: {\textcopyright} 2019 Wiley Periodicals, Inc. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.",
year = "2019",
month = nov,
day = "1",
doi = "10.1111/jce.14189",
language = "English (US)",
volume = "30",
pages = "2302--2309",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "11",
}