Cost comparison of radiofrequency modification and ablation of the atrioventricular junction in patients with chronic atrial fibrillation.
Background Because it is not clear which technique is less expensive, the purpose of this study was to compare the cost of radiofrequency modification and ablation of the atrioventricular (AV) node in drug-refractory patients with atrial fibrillation and an uncontrolled ventricular rate.
Methods and Results The initial nominal charges for a successful procedure were compared in 10 patients with chronic atrial fibrillation who underwent modification of the AV node ($13 109±2002) and 14 similar patients who underwent ablation and pacemaker implantation ($28 302±2023, P<. 001).
On the basis of the long-term follow-up of patients who underwent each procedure, it was assumed that 31% of patients selected for the modification procedure would require a permanent pacemaker for inadvertent AV block or because of AV nodal ablation after a failed modification procedure and that the recurrence rate after AV node ablation would be 2%. The annual charges during follow-up were predicted and adjusted for recurrences and the need for additional procedures.
The adjusted total charges at 1 year of follow-up were significantly lower for the modification procedure ($19 389±2002) than for the ablation procedure ($28 485±2023, P<. 001).
After 10 years of follow-up, the cumulative, adjusted charges for modification were $20 016 (42%) less than for ablation. (...)
Mots-clés Pascal : Fibrillation auriculaire, Chronique, Ablation, Noeud auriculoventriculaire, Radiofréquence, Analyse coût, Economie santé, Etude longitudinale, Traitement, Homme, Appareil circulatoire pathologie, Cardiopathie, Trouble rythme cardiaque, Trouble excitabilité, Traitement instrumental
Mots-clés Pascal anglais : Atrial fibrillation, Chronic, Ablation, Atrioventricular node, Radiofrequency, Cost analysis, Health economy, Follow up study, Treatment, Human, Cardiovascular disease, Heart disease, Arrhythmia, Excitability disorder, Instrumentation therapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0488847
Code Inist : 002B12A02. Création : 03/02/1998.