Conclusion Our systemic review and meta- analysis revealed further evidence that cryoballoon ablation is an equally effective alternative procedure to the st and ard radiofrequency treatment with a slightly , non-significant higher freedom from AF 1 year after the ablation and a shorter procedure time
Objective The aim of this study was to evaluate the clinical efficacy and safety outcomes of the treatment with cryoballoon ( CB ) compared to the treatment with traditional irrigated radiofrequency ablation ( RF ) for pulmonary vein isolation ( PVI ) in patients with paroxysmal atrial fibrillation ( pAF ) and refractory to antiarrhythmic drug therapy ( AAD ) .
Cost-Effectiveness of Radiofrequency Catheter Ablation Compared With Antiarrhythmic Drug Therapy for Paroxysmal Atrial Fibrillation
Background —Radiofrequency catheter ablation ( RFA ) has emerged as an important treatment strategy for atrial fibrillation ( AF ) . The potential cost-effectiveness of RFA for AF , relative to antiarrhythmic drug ( AAD ) therapy , has not been fully explored from a US perspective . Methods and Results —We constructed a Markov disease simulation model for a hypothetical cohort of patients with drug-refractory paroxysmal AF , treated either with RFA with/without AAD or AAD alone .  Costs and quality -adjusted life-years were projected over 5 years . Model inputs were drawn from published clinical trial and registry data , from new registry and trial data analysis , and from data prospect ively collected from patients with AF treated with RFA at our institution . We assumed no benefit from ablation on stroke , heart failure or death , but did estimate changes in quality -adjusted life expectancy using data from several AF cohorts . In the base case scenario , cumulative costs with the RFA and AAD strategies were $ 26 584 and $ 19 898 , respectively . Over 5 years , quality -adjusted life expectancy was 3.51 quality -adjusted life-years with RFA versus 3.38 for the AAD group . The incremental cost-effectiveness ratio for RFA versus AAD was thus $ 51 431 per quality -adjusted life-year . Model results were most sensitive to time horizon , the relative utility weights of successful ablation versus unsuccessful drug therapy , and to the cost of an ablation procedure . Conclusions —RFA with/without AAD for symptomatic , drug-refractory paroxysmal AF appears to be reasonably cost-effective compared with AAD therapy alone from the perspective of the US health care system , based on improved quality of life and avoidance of future health care costs
Conclusion Our systemic review and meta- analysis revealed further evidence that cryoballoon ablation is an equally effective alternative procedure to the st and ard radiofrequency treatment with a slightly , non-significant higher freedom from AF 1 year after the ablation and a shorter procedure time
Objective The aim of this study was to evaluate the clinical efficacy and safety outcomes of the treatment with cryoballoon ( CB ) compared to the treatment with traditional irrigated radiofrequency ablation ( RF ) for pulmonary vein isolation ( PVI ) in patients with paroxysmal atrial fibrillation ( pAF ) and refractory to antiarrhythmic drug therapy ( AAD ) .