Cost comparison of radiofrequency modification and ablation of the atrioventricular junction in patients with chronic atrial fibrillation

Bradley P. Knight, Raul Weiss, Marwan Bahu, Joseph Souza, Adam Zivin, Rajiva Goyal, Emile Daoud, K. Ching Man, S. Adam Strickberger, Fred Morady*

*Corresponding author for this work

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Background: Because it is not clear which technique is less expensive, the purpose of this study was to compare the cost of radiofrequency modification and ablation of the atrioventricular (AV) node in drug- refractory patients with atrial fibrillation and an uncontrolled ventricular rate. Methods and Results: The initial nominal charges for a successful procedure were compared in 10 patients with chronic atrial fibrillation who underwent modification of the AV node ($13 109±2002) and 14 similar patients who underwent ablation and pacemaker implantation ($28 302±2023, P<.001). On the basis of the long-term follow-up of patients who underwent each procedure, it was assumed that 31% of patients selected for the modification procedure would require a permanent pacemaker for inadvertent AV block or because of AV nodal ablation after a failed modification procedure and that the recurrence rate after AV node ablation would be 2%. The annual charges during follow-up were predicted and adjusted for recurrences and the need for additional procedures. The adjusted total charges at 1 year of follow-up were significantly lower for the modification procedure ($19 389±2002) than for the ablation procedure ($28 485±2023, P<.001). After 10 years of follow-up, the cumulative, adjusted charges for modification were $20 016 (42%) less than for ablation. Conclusions: The initial charges generated by AV node modification are significantly lower than fo AV node ablation in patients with chronic atrial fibrillation. Even when adjusted for higher failure and recurrence rates, the modification procedure retains a major cost advantage over ablation during long-term follow-up.

Original languageEnglish (US)
Pages (from-to)1532-1536
Number of pages5
JournalCirculation
Volume96
Issue number5
DOIs
StatePublished - Sep 2 1997

Keywords

  • Catheter ablation
  • Cost-benefit analysis
  • Fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Knight, B. P., Weiss, R., Bahu, M., Souza, J., Zivin, A., Goyal, R., Daoud, E., Man, K. C., Strickberger, S. A., & Morady, F. (1997). Cost comparison of radiofrequency modification and ablation of the atrioventricular junction in patients with chronic atrial fibrillation. Circulation, 96(5), 1532-1536. https://doi.org/10.1161/01.CIR.96.5.1532