Catheter ablation in the elderly in the United States: Use in the Medicarepopulation from 1991 to 1998

The safety and efficacy of catheter ablation for the treatment of drug refr actory cardiac arrhythmias is well established in young patients. Little is known about its effectiveness or use in the elderly. We determined trends in the use of catheter ablation in the United States Medicare population. D ata were obtained from the approximately 30 million patients covered each y ear by Medicare's fee-for-service program of the Health Care Financing Admi nistration of the Department of Health and Human Services. From 1991 to 199 8, Medicare's fee-far-service beneficiaries covered 80%-93% of all adults > 65 years old in the United States. AII catheter-based ablative procedures performed in this population were identified through the use of the Current Procedural Terminology codes 93650, 93651, and 93652. Use rate per 1 milli on beneficiaries grew from 33 in 1991 to 603 in 1998, While during this 7-y ear period the Medicare fee-for-service population decreased by 8%, ablatio ns increased 16-fold (1,608%). The use of catheter ablation in the older Am erican grew exponentially during the 1990s. Further research is needed to d etermine the optimal use of this potentially curative technique in the elde rly.