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The Costs of Atrial Fibrillation (AFib)

Medically Reviewed by Brunilda Nazario, MD on March 09, 2021

If you have atrial fibrillation, or AFib, you have great reasons to keep cost from getting in the way of your treatment. For one, it can cut your risk of having a stroke.

The good news is that millions of Americans lead long and active lives with AFib. You want to be among them. Exactly what costs you have to manage depends on what type of treatment you need and your insurance coverage. So educate yourself today about your condition and treatment costs -- and how to manage them.

Diagnostic Procedures

In addition to reviewing your symptoms and medical history, and doing a physical exam, your doctor will probably order one or more tests to diagnose AFib. These tests may include:

  • An electrocardiogram (ECG or EKG): An EKG picks up electrical signals through sensors attached to your chest and arms, and creates a paper picture as the impulses travel through your heart muscle. An EKG creates an electrical “snapshot” of your heartbeats.
  • Holter monitor: You carry a portable device in your pocket, or on a belt or shoulder strap, for 1 to 3 days. Wires lead from the device to electrodes on your chest and let a doctor evaluate your heart rhythm.
  • Portable event monitor: Someone whose irregular heartbeat is more occasional carries a portable EKG device for about a month. If you feel symptoms, you press a button. Then the monitor records your heart’s electrical activity and sends data over phone lines to your doctor’s office.
  • Echocardiogram: A wand-like device is held to your chest to send sound waves and take real-life moving images of your heart as it pumps.
  • Other tests: These include blood tests, stress tests, and chest X-rays.

A routine (non-emergency care) electrocardiogram usually costs $40 to $100, while an echocardiogram may cost anywhere from $75 to $225. Two days of holter monitoring can be found online for $300 to $350. Private insurance should cover diagnostic tests, if your doctor ordered them because you show AFib symptoms. Medicare Part B and Medicaid also cover these tests.

Medications to Reset or Maintain Heart Rhythm

Often, the next step after an AFib diagnosis may be to reset your heart rate and rhythm to normal.

Medications are usually the first treatment people try. Your doctor may recommend addressing your heart rhythm issue with medications you take by mouth or IV, often in the hospital under supervision. These antiarrhythmic medications may include:

These medications can be purchased online from $21 for amiodarone to $173 for dofetilide. Your 30% copay would range from $6.30 to $51.90.

Your doctor may recommend a procedure called electrical cardioversion, in which a low-voltage shock delivered by paddles stops your heart’s electrical activity for a moment. One study pegs the treatment costs around $1,600 per procedure. Like other AFib procedures, electrical cardioversion should be covered by private insurance, Medicare, and Medicaid, but you want to research your deductible, copay, or coinsurance costs.

Other Medications for AFib

You may need to take other medications during your AFib treatment, from these categories:

Heart rate control medications. These drugs help restore your heart rate to normal and include digoxin (Lanoxin), beta-blockers such as metoprolol (Toprol, Lopressor), and calcium channel blockers like diltiazem (Cardizem) or verapamil (Calan). Digoxin can be found online for $41 (30% copay $12.30) and metoprolol for just $18 ($5.40), but a verapamil prescription may cost $110 ($33).

Blood thinners. Your doctor may want you to take warfarin (Coumadin) to help prevent blood clots but may favor newer anticoagulants like apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Lixiana), or rivaroxaban (Xarelto). Generic warfarin can be found online for just $12, but the newer medications’ prices are in the $400 to $500 range ($120 to $150 copay).

If another condition is putting you at risk for AFib, you’ll need treatment for that condition, too.

Surgical Options

If cardioversion or medication doesn’t restore your heart rhythm, your doctor may recommend one of several surgical procedures. Possibilities include:

  • Catheter ablation, in which a doctor threads a long, thin tube from your groin through blood vessels to your heart. The tip of the tube then uses heat or cold to destroy the tissue that’s causing your uneven heartbeat.
  • Maze procedures, in which a surgeon creates scar tissue in your heart to interfere with the electrical impulses causing your AFib. This can be done with a laser or with newer techniques using radiofrequencies, lasers, and other alternatives to a scalpel.
  • Atrioventricular (AV) node ablation, in which a catheter delivers radiofrequencies to destroy a small area of tissue in the passage between the upper and lower chambers of your heart
  • A left atrial appendage procedure, in which a surgeon either removes the appendage or clips it off, in order to prevent blood clots

Heart surgeries are very expensive. For example, one study found the median patient cost for catheter ablation was $32,756. Your out-of-pocket costs for a procedure could easily reach your health plan’s annual maximum. You should find out in advance from your doctor’s office and insurance company what your share could be.

Helpful Tips

If you worry about the cost of AFib treatment, many drugmakers advertise programs that offer discounts. Also, taking part in a clinical trial may cut your treatment cost greatly. Clinical trials test new treatments to see how well they work and what side effects they may have. Your doctor can help you find a clinical trial that might be a good fit for you. You can also look, for yourself, on clinicaltrials.gov.

To help with your research, the American Heart Association maintains a web page with podcasts and webinars, message boards, and print resources for people with AFib.

WebMD Medical Reference

Sources

SOURCES:

SAGE Open Medicine: “Hospital and clinical care costs associated with atrial fibrillation for Medicare beneficiaries in the Cardiovascular Health Study and the Framingham Heart Study.”

Blue Cross and Blue Shield of Massachusetts: “Typical Costs for Common Medical Services.”

Cigna: “Heart Tests: When Do You Need Them?”

University of York (U.K.) Centre for Reviews and Dissemination: “Effectiveness and costs of chemical versus electrical cardioversion of atrial fibrillation.”

Journal of Cardiovascular Electrophysiology: “Patient and facility variation in costs of catheter ablation for atrial fibrillation.”

Mayo Clinic: “Clinical Trials,” “Atrial Fibrillation.”

American Heart Association: “AFib Resources for Patients and Professionals.”

Heart Foundation: “Adjusting to life with atrial fibrillation.”

AFibSurgeons.org: “Medical & Economic Burden of AFib,” “Top 7 Reasons to Treat AFib.”

BMC Health Services Research: “Cost of illness of atrial fibrillation: a nationwide study of societal impact.”

Cleveland Clinic: “Atrial Fibrillation.”

National Heart, Lung, and Blood Institute: “Atrial Fibrillation.”

American Heart Association: “Treatment Options of Atrial Fibrillation (AFIB or AF).”

American Journal of Managed Care Peer Exchange: “Atrial Fibrillation: Current Management and Best Practices.”

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