Martin-Doyle William, Reynolds Matthew R
University of Massachusetts Medical School, Worcester, MA.
Beth Israel Deaconess Medical Center.
J Atr Fibrillation. 2010 Aug 23;3(2):286. doi: 10.4022/jafib.286. eCollection 2010 Aug-Sep.
The use of catheter ablation to treat AF is increasing rapidly, but there is presently an incomplete understanding of its cost-effectiveness. AF ablation procedures involve significant up-front expenditures, but multiple randomized trials have demonstrated that ablation is more effective than antiarrhythmic drugs at maintaining sinus rhythm in a second-line and possibly first-line rhythm control setting. Although truly long-term data are limited, ablation, as compared with antiarrrhythmic drugs, also appears associated with improved symptoms and quality of life and a reduction in downstream hospitalization and other health care resource utilization. Several groups have developed cost effectiveness models comparing AF ablation primarily to antiarrhythmic drugs and the model results suggest that ablation likely falls within the range generally accepted as cost-effective in developed nations. This paper will review available information on the cost-effectiveness of catheter ablation for the treatment of atrial fibrillation, and discuss continued areas of uncertainty where further research is required.
导管消融术用于治疗房颤的情况正在迅速增加，但目前对其成本效益的理解并不完整。房颤消融手术前期费用高昂，但多项随机试验表明，在二线甚至可能是一线节律控制方面，消融术在维持窦性心律方面比抗心律失常药物更有效。尽管真正的长期数据有限，但与抗心律失常药物相比，消融术似乎还能改善症状和生活质量，并减少下游住院率和其他医疗资源的使用。有几个研究团队建立了成本效益模型，主要将房颤消融术与抗心律失常药物进行比较，模型结果表明，消融术可能处于发达国家普遍认为具有成本效益的范围内。本文将综述导管消融术治疗心房颤动成本效益的现有信息，并讨论仍存在不确定性、需要进一步研究的领域。
