BackgroundThere is a paucity of Canadian studies using patient-level data to analyse the costs of Catheter Ablation (CA) for atrial fibrillation (AF). We sought to identify the healthcare resource use, costs, and cost predictors of CA. MethodsA cost analysis was performed in a population of AF patients treated with CA in Central Zone Nova Scotia from 2010 – 2018. Costs were compared 2 years before ablation (pre-CA) to costs 2 years after (post-CA); the 3-month period after CA was defined as the treatment window. Costs were also compared by CA technology defined as pre-2015 treated with non-CFS CA and post-2015 treated with CFS CA. ResultsHeart failure hospitalizations, AF-related emergency department visits, acute inpatient admissions, and cardioversions all decreased after ablation. The cost difference post-CA vs. pre-CA was $18,869 (95% CI: $15,570; $22,168). This increase in costs was driven by costs incurred during the treatment window, which was $21,439 (95% CI: $20,468; $22,409). After excluding treatment window costs, the mean year 1 post-CA was $11,223 (95% CI: $9,113; $13,334) and year 2 post-CA cost was $4,555 (95% CI: $3,145; $5,965) were lower than the pre-CA costs. Costs remained stable over the timeframe of the study period, with no influence from new technologies on cost. The post-CA cost difference between the post-2015 and pre-2015 groups was $2,573 (95% CI: -$2,336; $7,481) ConclusionWe demonstrated that although CA is expensive, it may be a cost-effective treatment modality for AF given the reduction in costs and health care resource use associated.