Cost-effectiveness of catheter ablation for rhythm control of atrial fibrillation.
Cost-effectiveness of catheter ablation for rhythm control of atrial fibrillation.
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DOI：
10.1155/2013/262809
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发表时间：
2013
影响因子：
1.3
通讯作者：
Goeree R
中科院分区：
文献类型：
--
作者：
Blackhouse G;Assasi N;Xie F;Gaebel K;Campbell K;Healey JS;O'Reilly D;Goeree R
目标。本研究的目的是评价与抗心律失常药物(AAD)治疗相比较的导管消融术与抗心律失常药物(AAD)治疗在控制心律方面的成本效益。方法：研究方法。建立一个经济模型来比较(1)导管消融和(2)AAD(胺碘酮200 mg/d)。在模型的最初12个月阶段结束时，根据荟萃分析的数据，患者被分类为正常窦性心律或房颤患者。在模型的5年马尔可夫阶段，患者每3个月的模型周期有患缺血性中风的风险。结果。该模型估计，与AAD战略相比，在5年的时间范围内，消融的成本高出8,539美元，卒中减少0.033，QALY增加0.144。与AAD相比，每QALY消融的增量成本估计为59,194美元。对于愿意支付50,000美元和100,000美元阈值的人来说，消融具有成本效益的概率估计分别为0.89和0.90。结论。根据目前的证据，如果决策者愿意为QALY支付59,194美元或更高，肺静脉消融治疗房颤是具有成本效益的。
Objective. The objective of this study is to evaluate the cost-effectiveness of catheter ablation for rhythm control compared to antiarrhythmic drug (AAD) therapy in patients with atrial fibrillation (AF) who have previously failed on an AAD. Methods. An economic model was developed to compare (1) catheter ablation and (2) AAD (amiodarone 200 mg/day). At the end of the initial 12 month phase of the model, patients are classified as being in normal sinus rhythm or with AF, based on data from a meta-analysis. In the 5-year Markov phase of the model, patients are at risk of ischemic stroke each 3-month model cycle. Results. The model estimated that, compared to the AAD strategy, ablation had $8,539 higher costs, 0.033 fewer strokes, and 0.144 more QALYS over the 5-year time horizon. The incremental cost per QALY of ablation compared to AAD was estimated to be $59,194. The probability of ablation being cost-effective for willingness to pay thresholds of $50,000 and $100,000 was estimated to be 0.89 and 0.90, respectively. Conclusion. Based on current evidence, pulmonary vein ablation for treatment of AF is cost-effective if decision makers willingness to pay for a QALY is $59,194 or higher.
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影响因子：
24
作者：
Chan, Paul S.;Vijan, Sandeep;Oral, Hakan
通讯作者：
Oral, Hakan
DOI：
10.1111/j.1540-8167.2008.01275.x
发表时间：
2009-01-01
影响因子：
2.7
作者：
Forleo, Giovanni B.;Mantica, Massimo;Tondo, Claudio
通讯作者：
Tondo, Claudio
影响因子：
8.3
作者：
Hardie, K;Hankey, GJ;Anderson, C
通讯作者：
Anderson, C
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
影响因子：
37.8
作者：
Cappato, R;Calkins, H;Skanes, A
通讯作者：
Skanes, A