If I have an AF ablation without insurance, why is it so expensive?

So you’ve got Atrial fibrillation (AF) and you’ve considered your options for treatment – a lifestyle approach, medications, or an ablation.

You’ve decided that the best solution for you is an AF ablation.  You may be having this paid for by insurance, but more and more patients are saving on insurance premiums and deciding to pay for it themselves.

We offer self-pay packages for patients who are not insured and this is a growing part of the market and can offer more flexibility and choice.

If you do choose to go down the self-pay route, you may ask ‘why is this an expensive procedure?’

Like anything in life, we have to weigh up the cost of something against the benefits it can provide.

When it comes to your heart health, AF ablation can be the most effective way to ensure the heart beats effectively in selected groups of patients.

While it may seem like a large up-front cost, the benefits or reverting your heart in to a normal rhythm almost immediately, compared with the alternative of having a lifetime of medication can be hard to measure in terms of monetary value.

Not only is there the constant reminder that you need to take your medication, but there are also risks and side-effects of the medication, that should not be overlooked.

Of course, there are risks with ablation too, but it is usually a one-off procedure and could result in you not needing any medication to maintain your heart in a healthy heart beat rhythm.

Studies have shown that, in the right patient, AF ablation can be not only the most successful and in the long-term, safest way to treat your AF, but it is also the most cost-effective, when everything is considered.

…but even if you have accepted that it is the best way to treat your AF, then you may be wondering,

‘how do they justify the cost?’

Well, people are always surprised by how many people are involved in this procedure.

We have arrhythmia nurses to help smooth the process and counselling before and after the procedure.  In the room itself there is a scrub nurse to assist, a running nurse to get equipment, a radiographer to operate the X-ray machinery, a cardiac physiologist to operate the ablation equipment as well as the Anaesthetist and his assistant.  Afterwards there are the nurses in the recovery department, as well as the ward staff – nurses, ward clerk, porters, cleaners and so on.

The equipment costs are also significant.  A purpose-built catheter lab costs over a million pounds to build.  It needs to be lined with lead to prevent X-ray radiation leaking out, as well as meet operating room standards of cleanliness.  This includes filtered air at a higher pressure than outside so air flows out of the operating room at all times to minimise the chance of germs coming in.  The operating table needs to be able to take the weight of the patient and ancillary equipment, be able to be manoeuvred in the room to assist with procedures and be transparent to X-rays.  The X-ray equipment needs to move around the patient and be very sensitive to help up see the catheters inside the body.

We also use 3D mapping systems which cost over £100,000.  These act like a GPS system to localise catheters inside the heart and allow us to map the veins and additional connections.  The consumables for these systems are expensive – the conducting patches that are stuck to your back cost around £500 alone. 

The freezing console and the Radiofrequency consoles are of the order of £50,000 each and these enable the ablation to be performed.  The individual catheters that are placed in the heart and do the ablation are single use and cost over £1000 each.  There are also other diagnostic catheters – up to 4 used for each case.

We also use specialised custom sheaths which are often deflectable to help guide the catheters.  These are again single use.

The ultrasound machine costs a £100000 and the probe itself is £10,000!

So there’s a lot of kit and people involved which makes it amongst the most expensive health-care procedures you can have done, and probably the most expensive in which you don’t actually get a prosthesis or device implanted.

Is it worth it?  Well, the procedure has come on tremendously in the past decade as the kit has improved.  We are on the 3rd generation of cooling balloons, the RF catheters can now sense the contact force making ablation more effective and safer, and the mapping systems are getting better resolution all the time.  We may not be able to cure atrial fibrillation yet, but we can certainly improve symptoms for the majority of patients using this technique.

I am a cardiologist with a special interest in AF and electrophysiology, so I am able to offer the whole range of treatments for AF, including ablation.

If you want more information or would like to set up a free call to discuss your problems, please get in touch (link to contact page) and I would be happy to help.


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