Radiofrequency Catheter Ablation for Cardiac Arrhythmias: A Clinical and Economic Review
- ISBN-10
- 1894620399
- ISBN-13
- 9781894620390
- Pages
- 66
- Language
- English
- Published
- 2002
- Publisher
- Canadian Coordinating Office for Health Technology Assessment
Description
Catheter ablation is a treatment for patients with heart rhythm disturbances (cardiac arrtiythmias) called tachycardias. Tachycardias cause symptoms that degrade the quality of life of individuals and are a life-long medical problem. Some of them are common medical problems (such as atrial fibrillation) and many begin at a young age with the potential for life-long morbidity. Certain tachycardias can be life threatening. Drug therapy to control these tachycardias is often ineffective or causes intolerable side effects. Presently, catheter ablation delivered by radiofrequency energy (RPA) is the predominant procedure used for the treatment of tachycardias and may be curative or palliative. This is the first synthesis of research studies and economic evaluations of RFA in Canada. For the following conditions, RFA is associated with a high procedural success rate and a low rate of complications within two years of follow-up: a. Paroxysmal supraventricular tachycardia (PSVT) secondary to an accessory pathway. b. PSVT secondary to atrioventricular node re-entry c. Atrial flutter d. Focal and re-entrant atrial tachycardias. For the following conditions, catheter ablation is still within the research domain: a. Atrial fibrillation; b. Ventricular tachycardia (VT) in the setting of structural heart disease. In adult patients with either symptomatic PSVT or VT patients with implantable defibrillators who experience frequent recurrences, RFA is both more effective and less costly than drug therapy options. For these patients, RFA costs within US $21,000 (C $33,000) per quality-adjusted-life-year gained. For all the different types of ablation procedures, there is a paucity of high quality outcome studies comparing ablation with altemative therapies.
