Cost-effectiveness of catheter ablation for atrial fibrillation.
OBJECTIVE
Catheter ablation for atrial fibrillation is a rapidly evolving field. It has been adopted at many institutions worldwide. This review compares the efficacy and cost of catheter ablation and medical therapy in atrial fibrillation patients.


RESULTS
There is emerging evidence for clinical superiority of catheter ablation over medical therapy for restoring and maintaining sinus rhythm in atrial fibrillation patients. Early analyses of costs related to catheter ablation in atrial fibrillation suggest that medical therapy and catheter ablation become cost-equivalent at about 5 years of follow-up. A recent cost-effectiveness study concluded that catheter ablation is a cost-effective alternative to medical care in younger and older patients at low and moderate risk of stroke, assuming that restoration and maintenance of sinus rhythm with ablation would have some protective effect with respect to embolic events.


CONCLUSIONS
Catheter ablation is a potentially cost-effective strategy in select patients with atrial fibrillation. Long-term randomized studies that compare it to conventional care and focus on outcomes of morbidity and mortality are necessary prior to widespread application of this technique.
Khaykin
Yaariv
Y
Southlake Regional Health Center, Newmarket, Ontario, Canada. y.khaykin@utoronto.ca
D000925:Anticoagulants / Q000191:economics / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000191:economics / Q000601:surgery*; D017115:Catheter Ablation / Q000191:economics*; D003362:Cost-Benefit Analysis; D006339:Heart Rate / Q000187:drug effects; D006801:Humans
D000925:Anticoagulants