Bhatt Nikhilesh, Turakhia Mintu, Fogarty Thomas J
Fogarty Institute for Innovation.
Department of Cardiology, Stanford University School of Medicine.
Cureus. 2016 Aug 1;8(8):e720. doi: 10.7759/cureus.720.
In the United States (U.S.), atrial fibrillation (AF) is the second-most common cardiovascular condition after hypertension, affecting four million Americans each year. Individuals with AF are three times more likely to be hospitalized over the span of a year when compared to medically matched control groups. The considerably large clinical population of individuals with AF mandates that the cost-effectiveness and efficacy of current treatment regimens for AF have egregious implications for health care spending and public health. Unfortunately, catheter ablation for AF treatment has been shown to make only modest gains in quality-adjusted life years, has yet to demonstrate cost-utility advantages over conventional therapies for AF, and has a reported rate of recurrence for AF that is notably high. Thus, there is a major unmet clinical need for a therapeutic option to treat AF that produces more consistent and efficacious results that are cost-effective. Cardiac radiosurgery as a therapy for AF has the potential to be remarkably cost-effective and produce robust patient outcomes. CyberHeart Inc. has developed the world's first-ever cardiac radiosurgery (CRS) system designed to ablate the heart non-invasively. Procedures that ablate the heart utilizing the Cyberheart CRS system are anticipated to allow higher efficacy and more consistent results than current techniques such as catheter ablation. The aim of this study is to present the current healthcare utilization and expenditures in AF treatment, report the cost-effectiveness of catheter ablation for AF, and project the potential cost-effectiveness of cardiac radiosurgery for the treatment of AF.
在美国,心房颤动(AF)是仅次于高血压的第二常见心血管疾病,每年影响400万美国人。与医学上匹配的对照组相比,房颤患者在一年时间内住院的可能性要高出三倍。大量房颤患者的临床群体意味着,目前房颤治疗方案的成本效益和疗效对医疗保健支出和公共卫生有着重大影响。不幸的是,用于房颤治疗的导管消融术在质量调整生命年方面仅取得了适度的改善,尚未证明其相对于传统房颤治疗方法具有成本效益优势,而且据报道房颤复发率相当高。因此,对于治疗房颤的治疗选择存在重大未满足的临床需求,即需要一种能产生更一致、有效且具成本效益的治疗方法。心脏放射外科作为一种治疗房颤的方法,有可能具有显著的成本效益并产生良好的患者治疗效果。赛博心脏公司(CyberHeart Inc.)开发了世界上首个旨在非侵入性消融心脏的心脏放射外科(CRS)系统。预计使用赛博心脏CRS系统消融心脏的手术将比导管消融等现有技术具有更高的疗效和更一致的效果。本研究的目的是介绍房颤治疗当前的医疗保健利用情况和支出,报告房颤导管消融术的成本效益,并预测心脏放射外科治疗房颤的潜在成本效益。