Regional Volume of Atrial Fibrillation Catheter Ablation Is Not Associated With Increased Per Capita Medical Costs

ABSTRACT Background Catheter ablation (CA) for atrial fibrillation (AF) is a curative but high‐initial‐cost intervention. Amidst concerns that disseminating advanced medical technology drives up medical costs, we investigated whether higher regional CA volumes correlate with increased per capita medical costs in Japan's super‐aging society. Methods This ecological study analyzed data from 2022 across all 47 prefectures in Japan. Using principal component regression (PCR), we evaluated the association between AF CA volume and per capita medical costs, adjusting for comprehensive demographic, socioeconomic, and disease prevalence variables. Results The PCR model (R 2 = 0.54) revealed that regional cost variance is primarily driven by structural factors, specifically population aging and the prevalence of chronic diseases (e.g., hypertension, diabetes), rather than high‐cost interventions. Conversely, regional economic vitality and population inflow acted as cost‐suppressive factors. Crucially, the volume of AF CA procedures exerted no statistically significant upward influence on per capita medical costs (estimate: −0.69; 95% CI: −3.83 to 2.44; p = 0.66). Conclusions Regional healthcare cost variation is primarily governed by structural demographics and chronic diseases, rather than the adoption of AF CA. Our findings suggest that CA is a cost‐neutral intervention at the regional level, where initial procedural costs are likely offset by the prevention of expensive long‐term complications. CA should be viewed as a valid healthcare investment, rather than merely a driver of cost inflation.