Adverse psychological effects and costs associated with waiting for radiofrequency ablation

Justin L. Barclay, Patrick H. Gibson, Adele Lewis, Clare Wilson, Jonathan T. Affolter, Jitendra C. Patel, Neil W. Scott, David A. Alexander, Anna Maria Choy, Paul A. Broadhurst

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background Radiofrequency ablation (RFA) is undertaken as a potentially curative treatment for a variety of heart rhythm disturbances. Previous studies have demonstrated improved quality of life and reduced symptoms after ablation. In many health care environments waiting lists exist for scheduling of procedures. However, the psychological effects of waiting for radiofrequency ablation have not previously been assessed. We hypothesized that waiting for this intervention may be associated with increased psychological morbidity and health care costs. Methods Ninety-two patients scheduled for elective RFA completed repeated questionnaires comprising the Medical Outcomes Short Form 36, Hospital Anxiety and Depression Scale, and an in-house questionnaire designed to assess the burden of symptoms related to arrhythmia (arrhythmia-related burden score). Mean scores were generated and compared at time points while waiting, before and after the procedure. Regression analyses were carried out to identify predictors of increased psychological morbidity while waiting and immediately prior to the procedure. Health care costs during the waiting period as a consequence of arrhythmia were quantified. Results Mean scores for parameters of psychological morbidity worsened during the period of waiting and improved after the procedure. Predictors of adverse effects within the cohort varied according to the time point assessed for each of the measures of psychological morbidity. A conservative estimate of the health care cost incurred while waiting exceeds 181 pound per patient. Conclusions Waiting for radiofrequency ablation appears to be associated with adverse psychological effects and health care costs. These results may support strategies to reduce waiting times and prioritize resource allocation.

    Original languageEnglish
    Pages (from-to)719-726
    Number of pages8
    JournalPacing and Clinical Electrophysiology
    Volume36
    Issue number6
    DOIs
    Publication statusPublished - 2013

    Keywords

    • QUALITY-OF-LIFE
    • IMPACT
    • radiofrequency ablation
    • DEPRESSION
    • BYPASS GRAFT-SURGERY
    • HEALTH-CARE COSTS
    • ARRHYTHMIAS
    • MEDICAL THERAPY
    • psychological effects
    • PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA
    • ANXIETY
    • CATHETER ABLATION
    • quality of life
    • health economics

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