Regional Disparities in Atrial Fibrillation Catheter Ablation Based on the Japanese National Survey.

Background: The prevalence of atrial fibrillation (AF) has increased with aging populations, making catheter ablation essential. However, access to this treatment across regions, even with universal healthcare, is not well understood. This study aims to explore potential regional disparities in AF catheter ablation rates and identify associated factors.

Methods and results: This cross-sectional study analyzed data from the Vital Statistics survey of Japanese events in 2022 (124,947,000 people), the Japanese government Survey of Household Economy, the Survey on the Impact of the Diagnosis Procedure Combination System, and publicly available data from the Japan Heart Rhythm Society. Principal component regression analysis revealed that the number of AF hospitalizations exhibited a positive correlation with the prevalence of hypertension and the percentage of unemployed men. The number of ablations positively correlated with overtime hours, university graduate salaries, part-time employment rates, and the number of arrhythmia specialists. AF hospitalization rates exhibited a negative correlation with AF ablation rates. The number of arrhythmia specialists correlated positively with ablation rates but negatively with AF hospitalization rates.

Conclusions: Socioeconomic factors appear to influence AF hospitalizations and treatment decisions. An increase in arrhythmia specialists may optimize ablation rates and reduce AF hospitalization rates.