Leung Lisa Wm, Akhtar Zaki, Kontogiannis Christos, Imhoff Ryan J, Taylor Hannah, Gallagher Mark M
Department of Cardiology, St George's Hospital NHS Foundation Trust, London, UK.
Real-World Evidence and Late Phase Research, CTI Clinical Trial and Consulting Services Inc, Covington, KY, US.
Arrhythm Electrophysiol Rev. 2022 Apr;11:e13. doi: 10.15420/aer.2021.46.
Randomised evidence supports an early rhythm control strategy as treatment for AF, and catheter ablation outperforms medical therapy in terms of effectiveness when studied as first- and second-line treatment. Despite evidence consistently showing that catheter ablation treatment is superior to medical therapy in most AF patients, only a small proportion receive ablation, in some cases after a prolonged trial of ineffective medical therapy. Health economics research in electrophysiology remains limited but is recognised as being important in influencing positive change to ensure early access to ablation services for all eligible patients. Such information has informed the updated recommendations from the recently published National Institute for Health and Care Excellence clinical guideline on the diagnosis and management of AF, but increased awareness is needed to drive real-world adoption and to ensure patients are quickly referred to specialists. In this article, economic evaluations of catheter ablation versus medical therapy are reviewed.
随机对照证据支持将早期节律控制策略作为房颤的治疗方法,并且在作为一线和二线治疗进行研究时,导管消融在有效性方面优于药物治疗。尽管证据一直表明,在大多数房颤患者中,导管消融治疗优于药物治疗,但只有一小部分患者接受消融治疗,在某些情况下,是在经过长时间无效的药物治疗试验之后。电生理学方面的卫生经济学研究仍然有限,但被认为对于推动积极变革以确保所有符合条件的患者能够尽早获得消融服务非常重要。这些信息为最近发布的英国国家卫生与临床优化研究所关于房颤诊断和管理的临床指南中的更新建议提供了依据,但仍需要提高认识以推动实际应用,并确保患者能够迅速转诊至专科医生处。在本文中,对导管消融与药物治疗的经济学评估进行了综述。