Abstract
Abstract only Introduction: Dronedarone has shown clinical benefit vs sotalol in adults with atrial fibrillation (AF) post-ablation, but healthcare resource utilization (HCRU) in this setting is unknown. Methods: A retrospective, observational cohort study was conducted using IBM MarketScan® data (Jan 2012-Mar 2020) in adults with AF receiving dronedarone or sotalol post-ablation. Patients needed to have 12 months of pre-ablation data; follow-up ended at earliest of health-plan disenrollment, death or end of study (Dec 2020). Prevalence (events per 100 patient-years [PY]) was calculated for all-cause and cardiovascular (CV)-related HCRU (hospitalizations; emergency room [ER] visits; outpatient office visits; other outpatient services). Patients receiving sotalol were propensity score (PS)-matched 1:1 to patients receiving dronedarone and compared by univariate generalized linear models with Poisson distribution. Time-to-event (TTE) cumulative incidences for all-cause, CV-related and atrial tachyarrhythmia (ATA)-/AF-related hospitalization, and for pacemaker insertion, were compared by Kaplan-Meier analysis and log rank test. Results: After PS-matching, the dronedarone and sotalol (n=1600 per cohort) cohorts were successfully matched across several criteria (mean follow-up: ~28 months; age at ablation: ~61 years; proportion male: ~70%; hypertension: ~71%; heart failure: ~13%; mean CHA2DS2-VASc score: ~1.8; mean Charlson comorbidity index: ~0.8). Post-ablation, prevalence per 100 PY of all-cause hospitalization (24.0 vs 27.4), ER visits (53.1 vs 59.5) and other outpatient services (1140.1 vs 1184.5), and of CV-related hospitalization (8.4 vs 11.3), ER visits (8.5 vs 10.0) and outpatient office visits (379.6 vs 390.9), were significantly lower with dronedarone vs sotalol. Cumulative incidences were significantly lower with dronedarone vs sotalol ( Figure ). Conclusions: Post-ablation dronedarone was associated with lower HCRU vs sotalol.