title: Patient's age rather than severity of the arrhythmia influences the cost of medical treatment of atrioventricular nodal or atrioventricular reciprocating tachycardia.
abstract: OBJECTIVE
  Radiofrequency ablation (RFA) is considered the treatment of choice in cases of atrioventricular nodal reciprocating tachycardia (AVNRT) and atrioventricular reciprocating tachycardia (AVRT). Published studies suggest a considerable time gap between the onset of the arrhythmia, correct diagnosis, and RFA which may reach 10-15 years. The cost of medical treatment during that period may be substantial. The aim of the study was to calculate the annual direct medical cost of medical treatment of patients with AVNRT and AVRT and identify potential factors influencing this cost.
  
  
  METHODS
  Based on the consumption of particular resources and the unit costs of services in 2013, we calculated the annual direct medical cost of care for patients with AVNRT and AVRT in Poland. We adopted the public payer's and societal perspectives. Data on health resources was collected with a structured questionnaire and medical records of patients scheduled for RFA. Additional analyses were performed to identify factors influencing this cost.
  
  
  RESULTS
  We enrolled 82 patients: mean age 43.9 ± 14.1 years old and mean symptom duration before the RFA 13.0 ± 11.3 years. The median annual cost of medical treatment was 546 USD [312-957], 411 € [278-786], and 616 USD [369-1044], 464 € [235-721], for the public payer and the common perspective, respectively, with hospitalizations being the main cost component. In multivariate analysis, only the age of the patient significantly influenced this cost.
  
  
  CONCLUSIONS
  The annual cost of medical treatment of AVNRT or AVRT is substantial and dependent on the age of the patient rather than the severity of the arrhythmia (NCT01594814).
authors.affiliation: The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1 St., 02-637, Warsaw, Poland. mfarkowski@gmail.com.
authors.forename: Michal M
authors.initials: MM
authors.lastname: Farkowski
authors.affiliation: The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1 St., 02-637, Warsaw, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Pytkowski
authors.affiliation: The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1 St., 02-637, Warsaw, Poland.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Maciag
authors.affiliation: Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Dominik
authors.initials: D
authors.lastname: Golicki
authors.affiliation: The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1 St., 02-637, Warsaw, Poland.
authors.forename: Ilona
authors.initials: I
authors.lastname: Kowalik
authors.affiliation: Business School, Warsaw University of Technology, Warsaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Czech
authors.affiliation: Arion Hospitals Group, Lublin, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Rucinski
authors.affiliation: The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1 St., 02-637, Warsaw, Poland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Szwed
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D004651:Employment / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006334:Heart Function Tests / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D054139:Tachycardia, Reciprocating / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D014600:Utilization Review; D055815:Young Adult
keywords: AVNRT; AVRT; Cost; Medical treatment