Comparison of real-world clinical and economic outcomes between the ThermoCool® SF and ThermoCool® catheters in patients undergoing radiofrequency catheter ablation for atrial fibrillation
Received 13 July 2018
Accepted for publication 18 August 2018
Published 4 October 2018 Volume 2018:10 Pages 587—599
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Professor Dean Smith
Larry Chinitz,1 Laura J Goldstein,2 Andrea Barnow,2 Sonia Maccioni,2 Mehmet Daskiran,3 Iftekhar Kalsekar,4 Rahul Khanna4
1NYU Langone Health, New York, NY, USA; 2Johnson & Johnson Medical Devices, Irvine, CA, USA; 3Janssen, Raritan, NJ, USA; 4Johnson & Johnson Medical Device Epidemiology, New Brunswick, NJ, USA
Introduction: This study evaluated the real-world clinical and economic outcomes associated with the use of the ThermoCool® Surround Flow (SF) and ThermoCool® catheters in atrial fibrillation (AF) ablation.
Methods: Adults with AF who underwent catheter ablation between January 1, 2013, and December 31, 2016, in a hospital outpatient setting were identified from the Premier Healthcare Database. Using a search strategy of hospital-charge descriptors, patients were classified into two mutually exclusive groups: ThermoCool® SF catheter and ThermoCool® catheter. A generalized estimating equation was used to compare index admission cost. Survey logistic regression was used to compare the incidence of inpatient readmission, direct-current cardioversion (DCCV), and repeat ablation. Multivariable analyses were adjusted for hospital clustering and demographic, procedural, hospital, and comorbidity characteristics.
Results: There were 1,014 and 463 patients in the ThermoCool® SF and ThermoCool® groups, respectively. The ThermoCool® SF group had significantly lower odds of all-cause (odds ratio [OR] 0.45; 95% CI 0.27–0.76) and cardiovascular-related readmissions (OR 0.45; 95% CI 0.21–0.96), and DCCV (OR 0.61; 95% CI 0.42–0.88) than the ThermoCool® group. In patients susceptible to fluid overload, the ThermoCool® SF group had significantly lower odds of 12-month all-cause (OR 0.42; 95% CI 0.23–0.75), cardiovascular-related (OR 0.31; 95% CI 0.10–0.92), and AF-related readmissions (OR 0.18; 95% CI 0.04–0.80), and DCCV (OR 0.52; 95% CI 0.31–0.87) than the ThermoCool® group.
Conclusions: Using the ThermoCool® SF catheter for AF ablation was significantly associated with improved clinical outcomes compared with the ThermoCool® catheter.
Keywords: atrial fibrillation, radiofrequency ablation, irrigated-tip catheter, ThermoCool® Surround Flow catheter, ThermoCool® catheter
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]