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Cost of ablation for atrial flutter and AF if done privately?

I was only put on the waiting list for ablation this week & as I opted for GA the EP thinks it will be Novemberish when it's done. My AF has been behaving for the last few weeks following a pretty bad run but over the past couple of days has started up again (possibly due to the heat). Now wondering if I should have it done privately just to get it done more quickly. I would prefer to have it done under NHS as I feel it's 'safer' but now thinking of the waiting time. Does anyone have any idea of the cost? Thank you

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Hi Petrified, I recently had an AF ablation done in London and all up it cost around £16000. Definitely the way to go for me as didn't want to wait as symptoms were getting more regular. Hope that helps!

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Thanks - I thought it would be more expensive!!! Did you have GA? Hope it's been successful. Keep well

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Yep that included GA for me and the TEE so not too bad!

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I was quoted 15k ten years ago. Don't forget though that one ablation may not fix the problem. I've had 3 and another in the pipeline.

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OK, thanks for replying. Not sure about going down the private route as many of the'stories' I've heard not been positive!!! Still thinking.

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Here in the states my bill was $67K for an ablation and one night in the hospital. And the doctor bills separately! Private insurance paid for all but $250. And, of course, they didn't pay the entire bill but got a significant discount.

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The differences in costs between health care in US and Europe still continues to stagger me! How on earth can they justify that amount of money?

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I was quoted $109,000 for a cardiovertion then discounted me cos of no inssurance to 14,200 then when I rang to cancel quoted me 4,200!

It's a joke & eliquis is $420 a month

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As a comparison, I’ve had 2 EP studies and ablations in a private hospital in Australia which included overnight stays in the CCU. All up they were around A$20,000 each (GB£11,200 $US$11,800). The costs were fully covered by Medicare and my private health insurance. Many people here complain about the cost of healthcare and insurance but I don’t think we have it to bad.

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But in the UK we don’t need to pay for health insurance and therefore the figure you quote should read £0

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Yeah, I was just quoting the exchange rate. I could get it done under the public system in Australia (Medicare) which would be free for me too but I would be subject to waiting lists (or I could return to England where I was born and have it done on the NHS :) At least by using my insurance I can choose my doctor and hospital and have it done when it suits me.

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I had one in Jan of this year, estimated at $117,000.00 at the Cleveland Clinic in the US for a overnight stay. It ended up at $189,000.00 since I ended up in ICU from complications of cardiac tamponade during surgery. Surgery was stopped halfway through and have another assigned for Sept. 25th. I went out of network with my insurance company so it only paid for 70% plus a $6,000.00 deductible.

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For reasons still don't fully comprehend, the "list price" for medical procedures in US is largely irrelevant. The health insurance companies have huge discounts off those prices, and even if one has no insurance hospitals will often gladly accept 40% of the list price as full payment. Have asked several MD's about it and they have said think "list" prices are high so that it "appears" that US Medicare is receiving tremendous discounts, and the inflated "list" prices are sometimes used in lawsuits as the alleged cost of injuries.

Late last year my wife fell in a US airport and was taken by ambulance to a hospital. Thankfully, her injuries were not terrible, but they took 4 CAT scans with a list price of $16,000. Under her insurance coverage, the CAT scans were discounted to 0...yes nothing!

The overall bill was around $30K, but after insurance contract adjustment was more like $4K, and we paid a relatively small portion of that.

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I've had an ablation performed privately and under GA in London but his week. I'm covered by insurance so haven't seen the final bill yet so can't comment on the cost. I'm not sure why you feel the NHS is safer as the same consultants work in both NHS and private practice. You should certainly be able to be seen more quickly taking the private route. It's conceivable that delaying treatment and allowing your heart to continue to malfunction could exacerbate your problems.

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It’s not only about the consultants. Just not same level of 24/7 support expertise and back up in the case of any clinical emergency in the private sector

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When waiting over a year with the NHS for aortic valve replacement I had quotes to have it done privately at three hospitals. One was £35K and another £28K. The third said that they would undercut that but to be prepared to possibly have an additional cost for a pacemaker.

The £28K said it was an eight week wait on his private list and thirteen for his NHS one so I elected to wait although it actually stretched out to nearly six months. He said that if I having it done privately and I needed a pacemaker they would whip me down the corridor to an NHS theatre and fit it there.

After I told his secretary that I would wait for the NHS she phoned back saying that he could fit me in two weeks by bringing his team in on Boxing Day (December 26th)

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As someone else has pointed out - if you do go privately choose an EP who works in a large London facility close to an NHS specialist cardiac centre. London Bridge would be a good example - next to GSTT

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The difference used to be that the NHS is regulated and private not, I don't know if that is still now the case. NHS has a lot more equipment and consultants if something should go wrong than a private hospital. Having been in both, the accommodation and food are far superior in a private hospital. I was also told you're far less likely to get an infection in a private one.

If it were me I would wait the 5 months and have the ablation performed by the NHS. I've had 3 under their care and my EP also does private ablations.

Jean

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Thanks for the reply. Pretty much what I'm thinking but exploring the options

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Jean I think that has always been the traditional argument but I don’t think that is the case these days. Many of the private hospitals are as well and sometimes better equipped and staffed than NHS in many, but not all disciplines.

I had both ablations performed privately in a London hospital - I couldn’t fault the care. And there were many NHS sponsored patients there having procedures. My husband attends a private dermatology clinic - on the NHS. Many specialist nurses in NHS settings are privately funded. These days it’s really hard to separate and know.

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I'm sure that could be the case with larger London private hospitals, but at the smaller ones if a problem occurred backup surgeons (if needed) may not be so readily available.

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I began my diagnosis in my local NHS hospital and couldn’t fault the service other than for the delays between appointments. I could have used the private facility next door and used the same consultants but decided to seek recommendations. The consultant recommended is based in London - just one hour away by train for me - so that’s where I ended up. In my recent experience of elderly relatives in an NHS facility there seems to be a greater risk there of secondary infections of one sort or another there.

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From what I've seen, I think the treatment of elderly patients in NHS hospitals is a disgrace.

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This is my main reservation. If anything untoward happens in the private sector then you're transferred to the care of the NHS. I'm sure it'll be quite different in London.

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Just read your post. My ablation was $68,000. Insurance paid all but $1700.00. That did not include pre and post op testing, labs, X-rays, overnight monitors, etc.that did not include doctor fee-which was about $12,000. Cost in the US is ridiculous, but a person doesn’t have a hard time getting care when they need it. Hope all goes well for you. Anxiety will increase your afib. Deep breaths and hang in there.

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Possibly - but then I wouldn’t be choosing that sort of hospital for ablation period. This type of procedure needs a specialist Centre of Excellence, in my opinion so I don’t think it would apply to PVI ablation procedure - but could for cardioversion.

Although after Bob’s experience - think I would want that done in CoE too!

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Not the equipment and lab that Papworth have I’m afraid.

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Its not so much the equipment as quick access to help from other surgeons should they be needed.

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When I had a scan at our local private hospital there was a Romanian doctor in attendance as I'd previously had a reaction to the dye used. He said that the specialists just come in and do their bit and go and that he is the only one there for the rest of the time. He is there on call 24/7 for two weeks at a time.

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I am an Expat living in Spain and consider myself very fortunate indeed. I was diagnosed as having a blocked artery and having AF and within 6 months I have had numerous scans, two failed attempts to fit a stent (impossible as complete bockage of artery) and two ablations. I can not praise the Spansh Health System enough. My second ablation so far appears to have been a success and I am now waiting to see how they proceed with the blocked artery situation. Had I been living in the UK god knows how long I would have waited for just one of these procedures.

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Depends where you live as most things in the NHS I suppose. I live in Herefordshire and had my delayed annual visit 10 days ago. He put me into the EP’s clinic which was yesterday and he has booked me in for an ablation under GA in September. Maybe I got lucky as the EP visits from Birmingham and only has a clinic every 6 weeks and then we have the procedure at Birmingham.

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Seems to be the Postcode lottery in UK, some people get lucky but I suspect the majority dont. I wish you well Yorkie.

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I live in Yeovil Somerset I saw the EP from Bristol in the March of 2017 as he was visiting Yeovil hospital and he offered me an ablation so I agreed as my symptoms were becoming more problematic. I have the op on May 2nd 2018 a 13 month wait but I have to say it was certainty worth the wait as I have AF free apart from an hour episode on day 6 but yes it a lottery.

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I couldn’t agree more ,

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You must be concerned as to what will happen post Brexit

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Yes Seasider, I and many other Epats are concerned about what arrangements will or will not be made for Health cover in the EU. I hope common sense prevails and reciprical arrangements are made. In the event of a No Deal, then I am unsure what will happen. I have been legally resident in Spain for 15 years now. I hope the UK Government and the EU get it sorted PDQ as it is in everyones interest.

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I really liked the Spanish healthcare as well, I found it just far more streamlined and efficient than the NHS - which is currently rated 17th in the world - according to radio 4 report a week or so ago.

But we get what we pay for - and we pay very, very little proportionally to other systems.

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I have been treated in Spain and we have many friends who live there full-time and all sing the praises of the Spanish healthcare system. My friend needs a hip replacement and the doctor apologised and said it could be 2-3 months wait!

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All 4 of mine done privately which I was very happy about as not had good experiences in NHS. Cost depends on length and complications if any.

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I am surprised at the price would have thought it would have been more expensive. It may be that you can have it done privately but in an NHS hospital.

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I think you should budget up to £30k in case any complications set in. Phone up your local private hospitals and ask for some quotes.

But I don't understand why you want it under GA. When sedated they are able to ask you questions and get you to move so the procedure is much faster (and hence cheaper if private).

I'd also say that private is a lot safer than NHS. First of all you get the top EP doing it, not one of his/her underlings. Also there's a surgeon on hand reading the paper in case anything goes wrong whereas on NHS they have to call for the crash team which will be a load of juniors.

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I had mine done on nhs and as there is an aneathatist and cardiologist already there that is the crash team. So they don’t need to call anyone.

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A cardiologist can't open you up if something goes wrong - that needs a cardio-thorasic surgeon. In the NHS there will be one on call but if he's in another operation you may have a wait. Private is usually always safer which of course is one of the things you are paying for.

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Not sure about costs. However, I didn’t fancy having this done while awake.

Ok so I ended up having Three Ablation . All while awake, my EP understood my pain threshold and gave me plenty of local to keep me calm and relaxed.

I had no problems at all.

Have a rethink about having it done sooner under local

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I was given sedatives, not just a local, and was asleep for the majority of the time and I didn’t remember much.

Pettrified - GA carries higher risks and longer recovery time. Please ask more about sedation.

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Hello Petrified . My husband had his done privately at Papworth by a very experienced EP consultant.

It cost about 12k but worth every penny. The aftercare is brilliant. What’s the point in having money if you can’t use it to improve your health.

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If you only have to wait until November, I would wait and save the money. I was diagnosed in May last year but didn't get to see an EP until November. I was then put on his 12 month waiting list for ablation, and in March when I asked his secretary she told me the list has slipped at least a month. Looking like Christmas time for me . . .

However, if you have the money, I don't want to put you off the private route. It just doesn't seem appropriate for me personally.

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I had my ablation three years ago at London Bridge cost about £13000 at the time including GA and TOE. My reasoning was that I wanted the best consultant possible and to make sure that he did it personally. He did and it was brilliantly successful.

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Bordeaux would be the place to go ?

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Thank for all your feedback - lot to consider. EP I saw works out of the Golden Jubilee here in Scotland. He, and the hospital, do have a good reputation & I've no concerns about that. Really wouldn't want to face the journey from London after the ablation!!! Reason for opting for a GA is that 2 of the Cardiologists that I have seen both advised against ablation as 'its a most unpleasant experience'!!! Quite a downer!!!!

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Wow very enlightening responses. Especially about pricing...it's wrong just wrong, everyone should be afforded the same level of treatment

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And how do you think consultants would earn what they deserve ? NHS salaries are deliberately set low and they expect doctors who reach the level of consultant to then make extra by performing private work.

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