Aaron McCracken is an employee of Biosense Webster.
Cost Comparison of Catheter Ablation and Medical Therapy in Atrial Fibrillation
Article first published online: 30 JUL 2007
Journal of Cardiovascular Electrophysiology
Volume 18, Issue 9, pages 907–913, September 2007
How to Cite
KHAYKIN, Y., MORILLO, C. A., SKANES, A. C., MCCRACKEN, A., HUMPHRIES, K. and KERR, C. R. (2007), Cost Comparison of Catheter Ablation and Medical Therapy in Atrial Fibrillation. Journal of Cardiovascular Electrophysiology, 18: 907–913. doi: 10.1111/j.1540-8167.2007.00902.x
Dr. Allan C. Skanes received a speaker's honoraria from Biosense Webster.
Manuscript received 5 March 2007; Revised manuscript received 19 April 2007; Accepted for publication 15 May 2007.
- Issue published online: 30 JUL 2007
- Article first published online: 30 JUL 2007
- atrial fibrillation;
- catheter ablation;
- pulmonary veins;
- health economics
Introduction: There is emerging evidence for clinical superiority of catheter ablation over rate and rhythm control strategies in paroxysmal atrial fibrillation (PAF). The objective of this study was to compare costs related to medical therapy versus catheter ablation for PAF in Ontario (Canada).
Methods: Costs related to medical therapy in the analysis included the cost of anticoagulation, rate and rhythm control medications, noninvasive testing, physician follow-up visits, and hospital admissions, as well as the cost of complications related to this management strategy. Costs related to catheter ablation were assumed to include the cost of the ablation tools (electroanatomic mapping or intracardiac echocardiography-guided pulmonary vein ablation), hospital and physician billings, and costs related to periprocedural medical care and complications. Costs related to these various elements were obtained from the Canadian Registry of Atrial Fibrillation (CARAF), government fee schedules, and published data. Sensitivity analyses looking at a range of initial success rates (50–75%) and late attrition rates (1–5%), prevalence of congestive heart failure (CHF) (20–60%), as well as discounting varying from 3% to 5% per year were performed.
Results: The cost of catheter ablation ranged from $16,278 to $21,294, with an annual cost of $1,597 to $2,132. The annual cost of medical therapy ranged from $4,176 to $5,060. Costs of ongoing medical therapy and catheter ablation for PAF equalized at 3.2–8.4 years of follow-up.
Conclusion: Catheter ablation is a fiscally sensible alternative to medical therapy in PAF with cost equivalence after 4 years.