Cost-effectiveness of radiofrequency catheter ablation for atrial fibrillation
Cost-effectiveness of radiofrequency catheter ablation for atrial fibrillation
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DOI：
10.1016/j.jacc.2006.01.070
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发表时间：
2006-06-20
影响因子：
24
通讯作者：
Oral, Hakan
中科院分区：
文献类型：
--
作者：
Chan, Paul S.;Vijan, Sandeep;Oral, Hakan
我们试图比较左心房导管消融（LACA）、胺碘酮和心率控制治疗在治疗心房颤动（AF）中的成本效益。方法我们建立了一个决策分析模型来评估LACA在55年和65年的成本效益。中、低卒中风险的老年房颤队列。成本、卫生设施和转移概率来自已发表的文献和医疗保险数据。我们进行了主要阈值分析，以确定LACA疗效和卒中风险降低的最低水平，使LACA成本效益为每质量调整生命年（QALY）阈值50，000美元和100，000美元。在窦性心律恢复的LACA有效率为80%的情况下，卒中风险的相对降低需要>= 42%和>= 11%，以产生增量成本效果比（ICER）
OBJECTIVES We sought to compare the cost-effectiveness of left atrial catheter ablation (LACA), amiodarone, and rate control therapy in the management of atrial fibrillation (AF).BACKGROUND Left atrial catheter ablation has been performed to eliminate AF, but its cost-efectiveness is unknown.METHODS We developed a decision-analytic model to evaluate the cost-efectiveness of LACA in 55-and 65-year-old cohorts with AF at moderate and low stroke risk. Costs, health utilities, and transition probabilities were derived from published literature and Medicare data. We performed primary threshold analyses to determine the minimum level of LACA efficacy and stroke risk reduction needed to make LACA cost-effective at $50,000 and $100,000 per quality-adjusted life-year (QALY) thresholds.RESULTS In 65-year-old subjects with AF at moderate stroke risk, relative reduction in stroke risk with an 80% LACA efficacy rate for sinus rhythm restoration would need to be >= 42% and >= 11% to yield incremental cost-effectiveness ratios (ICERs)