title: Cost-effectiveness of radiofrequency catheter ablation for the treatment of atrial fibrillation in the United Kingdom.
abstract: OBJECTIVE
  To assess the cost-effectiveness of radiofrequency catheter ablation (RFCA) compared with anti-arrhythmic drug (AAD) therapy for the treatment of atrial fibrillation (AF) from the perspective of the UK NHS.
  
  
  METHODS
  Bayesian evidence synthesis and decision analytical model.
  
  
  METHODS
  A systematic review and meta-analysis was conducted and Bayesian statistical methods used to synthesise the effectiveness evidence from randomised control trials. A decision analytical model was developed to assess the costs and consequences associated with the primary outcome of the trials over a lifetime time horizon.
  
  
  METHODS
  Costs from a health service perspective and outcomes measured as quality-adjusted life years (QALYs).
  
  
  RESULTS
  The incremental cost-effectiveness ratio of RFCA varied between pound7763 and pound7910 for each additional QALY according to baseline risk of stroke, with a probability of being cost-effective from 0.98 to 0.99 for a cost-effectiveness threshold of pound20 000. Results were sensitive to the duration of quality of life benefits from treatment.
  
  
  CONCLUSIONS
  RFCA is potentially cost-effective for the treatment of paroxysmal AF in patients' predominantly refractory to AAD therapy provided the quality-of-life benefits from treatment are maintained for more than 5 years. These findings remain subject to limitations in the existing evidence regarding the nature of life benefits and the prognostic importance of restoring normal sinus rhythm conferred using RFCA.
authors.affiliation: Centre for Health Economics, University of York, Heslington, UK. cm535@york.ac.uk
authors.forename: C
authors.initials: C
authors.lastname: McKenna
authors.forename: S
authors.initials: S
authors.lastname: Palmer
authors.forename: M
authors.initials: M
authors.lastname: Rodgers
authors.forename: D
authors.initials: D
authors.lastname: Chambers
authors.forename: N
authors.initials: N
authors.lastname: Hawkins
authors.forename: S
authors.initials: S
authors.lastname: Golder
authors.forename: S
authors.initials: S
authors.lastname: Van Hout
authors.forename: C
authors.initials: C
authors.lastname: Pepper
authors.forename: D
authors.initials: D
authors.lastname: Todd
authors.forename: N
authors.initials: N
authors.lastname: Woolacott
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000191:economics / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000191:economics / Q000628:therapy*; D001499:Bayes Theorem; D017115:Catheter Ablation / Q000191:economics*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D006801:Humans; D019057:Quality-Adjusted Life Years; D020521:Stroke / Q000191:economics / Q000517:prevention & control; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D000889:Anti-Arrhythmia Agents