Review of economic evaluations of radiofrequency catheter ablation for cardiac arrhythmias.
A systematic review of current studies on the cost effectiveness of catheter ablation for treatment of tachycardia in adults was undertaken. The results are summarized based on a predefined framework of principles for economic evaluation. Of 192 abstracts identified, only three cost effectiveness studies were identified. Each focused on a different and specific patient group with selected target disorders, and used decision analysis modelling to estimate cost effectiveness. Radiofrequency catheter ablation is likely to be economically attractive compared with drug therapy in adult patients with frequently symptomatic paroxysmal supraventricular tachycardia (radiofrequency catheter ablation dominates drug therapy options) or in ventricular tachycardia patients with pre-existing ischemic coronary disease (cost effectiveness ratio of about US $21,000 per quality adjusted life year), but not in the treatment of asymptomatic Wolff-Parkinson-White syndrome patients. However, these studies evaluated different types of tachycardias in differing patient populations and all are based on United States data, so decision-makers must be cautious when applying these results to a general population with tachycardia in the Canadian context.
Department of Clinical Epidemiology and Biostatistics, McMaster University and Centre for Evaluation of Medicines, St Joseph's Hospital, Hamilton, Canada. marshd@mcmaster.ca
Deborah A
DA
Marshall
Bernie J
BJ
O'Brien
Graham
G
Nichol
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000191:economics / Q000601:surgery*; D017115:Catheter Ablation / Q000191:economics* / Q000379:methods; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D009864:Ontario; D019057:Quality-Adjusted Life Years; D012720:Severity of Illness Index