The Costs of Atrial Fibrillation (AFib)

Medically Reviewed by James Beckerman, MD, FACC on April 07, 2023
6 min read

If you have atrial fibrillation, or AFib, treating it cuts your risk of having a stroke. But it can be costly, even if you have insurance. 

Research shows you're more likely to need medical care (especially in the year after diagnosis) than those who don't have the condition. You're also more likely to have twice the amount of hospitalizations compared to people without it. 

With AFib on the rise, it's a good idea to understand the costs involved. When you know what your insurance covers and how to get help with treatment costs, you're better prepared for what's to come.

A report looked at how much money you may have to spend to treat AFib. In the first year after diagnosis, people with the condition:

Saw doctors on average nine times more than people without AFib. They went to the emergency room, were hospitalized, and were on more prescription drugs compared to people who didn't have AFib. They also had average out-of-pocket costs of $2,106, compared to $877 for people without AFib.

Had average medical costs of $23,306. That's compared to $4,839 in those without AFib. Another study puts the average total health care costs for people with AFib at $27,896 more than those who don't have it.

Saw doctors less if they lived in rural areas. But they had more urgent care visits and used more medicines.

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

An electrocardiogram(ECG or EKG). An EKG picks up electrical signals through sensors attached to your chest and arms. It creates a picture as the impulses travel through your heart muscle. Cost: $100-$300.

Holter monitor. This portable device goes in your pocket or on a belt or shoulder strap for 1 to 3 days. It has wires with electrodes you stick to your chest. This allows your doctor to evaluate your heart rhythm. Cost: $110-$1,300.

Portable event monitor. If you have an irregular heartbeat that's ongoing, your doctor may ask you to carry 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. Cost: $284-$783.

Echocardiogram. A technician holds a wand-like device to your chest to send sound waves and take real-life pictures of your heart as it pumps. Cost:  $1,000-$3,000.

Other tests: These include blood tests, stress tests ($1,100-$2,775), and chest X-rays ($110 to $270).

* All prices are without insurance. They were collected at the time this was published.

Private insurance may cover some or all of the cost for diagnostic tests if your doctor ordered them because you show signs of AFib. Medicare Part B and Medicaid also cover these tests.

A recent study found that screening for AFib with a wearable device could be a cheaper alternative to general screenings. But it's not an official diagnosis. You'd still need follow-up tests to confirm. 

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

Antiarrhythmic m edications are usually the first treatment people try. Your doctor may recommend drugs you take by mouth or through a vein (IV) at the hospital. These medications may include:

  • Amiodarone : A 30-day supply of 200 milligram tablets for 30 days costs $8.64-$15.63.
    (Cordarone , Nexterone, Paceron): $153-$156.76
  • Disopyramide: A 30-day supply of 100 milligram capsules ranges from $51.49 to $163.26. 
    (Norpace , Norpace CR): 21 capsules costs $106.14-$109.06
  • Dofetilide: A 28-day supply of 250 microgram capsules ranges from $24.45 to $172.69. 
    (Tikosyn): $337.83-$352.58 for 30 capsules
  • Dronedarone (Multag): No generic available. A 28-day supply of 400 milligram tablets ranges from $363.25 to $379.53.
  • Flecainide acetate: No brand name available. A 30-day supply of 50 milligram tablets ranges from $10.58 to $32.78.
  • Propafenone: A 30-day supply of 150 milligram tablets ranges from $8.22 to $44.31. 
    (Rythmol): $199.93-$206.37
  • Sotalol : A 30-day supply of 80 milligram tablets ranges from $5.95 to $20.28. 
    (Betapace): $512.79-$538.08

 

 

You may also need to take heart rate control and blood thinning medications (to ward off blood clots that can lead to stroke) during your AFib treatment. These include:

Heart rate control medications

  • Digoxin: A 30-day supply of 125 microgram tablets is $2.58-$16.12. 
    (Lanoxin): $225.14-$233.10
  • Metoprolol succinate: A 30-day supply of 25 milligram tablets is about $3.07-$12.42. 
    (Toprol XL): $44.12-$49.26 
  • Diltiazem : A 30-day supply of 240 milligram capsules is $4.99-$18.03. 
    (Cardizem): $78.35-$81.62 
  • Verapamil: A 30-day supply of 240 milligram tablets is $3.35-$16.32. 
    ( Calan): $274.41-$285.34 

Blood thinners 

  • Warfarin: A 30-day supply of 5 milligram tablets is $3.68-$11.64. 
    (Coumadin): $75.79-$79.12 
  • Apixaban (Eliquis): No generic available. A 30-day supply of 5 milligram tablets ranges from $289.25 to $301.08.
  • Dabigatran. The average cost for 60 capsules is $115.62-$416.39. 
    (Pradaxa) $408.96-$428
  • Edoxaban (Savaysa): No generic available. A 30-day supply of 60-milligram tablets ranges from $397.54 to $415.89.
  • Rivaroxaban (Xarelto). A 30-day supply of 20 milligram tablets ranges from $550.29 to $629.99

If another condition is putting you at risk for AFib, you’ll need treatment for that, too. It's hard to predict how much everything will cost because it depends on which medications you have to take, how often and how much you have to take, and any insurance coverage. Some research says medical therapy could run about $4,176-$5,060 per year.  

Your doctor may recommend a procedure called electrical cardioversion. That's when they use low-voltage shock to try to reset your heart's rhythm. You'll be asleep during the procedure.

Like other AFib procedures, electrical cardioversion should be covered by private insurance, Medicare, and Medicaid. But you'll want to research your deductible, copay, or coinsurance costs.

 

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

Catheter ablation . Your doctor threads a long, thin tube from your groin to your heart. They heat or cool the tip of the tube to destroy the tissue that’s triggering your uneven heartbeat.

Maze procedures. Your surgeon creates scar tissue in your heart to interfere with the electrical impulses causing your AFib. This can be done with newer techniques that don't use a scalpel.

Atrioventricular (AV) node ablation. 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. Your surgeon removes the appendage or clips it off to stop blood clots .

Pacemaker insertion. Your doctor may suggest this if you have AFib and another arrhythmia. You'll also need to take blood-thinning drugs.

Heart surgeries are very expensive. For example, one study found the average cost for catheter ablation ranged anywhere from about $21,000 to $26,000. A pacemaker can run anywhere from $26,000-$68,000. 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 how much you'll have to pay for a procedure.

If you worry about the cost of AFib treatment, many drugmakers have 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 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.

These prices are estimates based on the time when this article was published. Estimates include online coupons that may be available. Prices may vary based on where you live.