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Economic evaluation of an ultra-high density mapping system compared to non-ultra-high density mapping systems for radiofrequency catheter ablation procedures in patients with atrial fibrillation

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Abstract

Purpose

Advanced non-fluoroscopic mapping systems for radiofrequency ablation (RFA) have shown to be an effective treatment of atrial fibrillation. This study analyzes the resource usage and subsequent costs associated with the implementation of an ultra-high density mapping system (UHDMS) compared to non-ultra-high density mapping systems (NUHDMS).

Methods

This retrospective observational study included 120 patients (18 years or older) with paroxysmal or persistent atrial fibrillation who underwent RFA for de novo pulmonary vein isolation guided either by an UHDMS (n=63) or NUHDMS (n=57) for their index procedure. We compared patient characteristics, short- and long-term procedural outcomes, resource usage, and clinical outcomes followed up to 16 months between the two treatment groups. The cost analysis was conducted from the perspective of a single center in Spain (Clinica Universidad de Navarra).

Results

Neither baseline patient characteristics nor complication rate differed between groups. Repeat RFAs following recurrent arrhythmia at 16 months was lower in the UHDMS patient group than in the NUHDMS group (6 vs. 14, respectively; P=0.027). The average total cost per patient was €1,600 lower in the UHDMS group, compared to the NUHDMS group (€11,061 and €12,661, respectively; P=0.03).

Conclusion

In patients treated with an NUHDMS, 25% had a repeat ablation for recurrent arrhythmia, whereas only 9% of patients treated with a UHDMS had one (61% relative risk reduction), resulting in an average cost saving per patient of €1,600.

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Funding

This work was supported by funding from Boston Scientific.

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Authors and Affiliations

  1. Department of Cardiology and Cardiac Surgery, IdiSNA, Navarra Institute for Health Research, Arrhythmia Unit, Clinica Universidad de Navarra, University of Navarra and School of Medicine, Avda Pio XII sn, 31008, Pamplona, Spain

    Bernardo Wise, Ramón Albarrán-Rincón, Pablo Ramos & Ignacio García-Bolao

  2. Boston Scientific Corporation, Boston, MA, USA

    Alfonso De Lossada Juste, Ane Erkiaga Aio & Armin Klesius

  3. Health Economics and Outcomes Research Team, Deloitte Consulting & Advisory, Zaventem, Belgium

    Eliana Biundo, Edith Maes & Audrey Cordon

Authors
  1. Bernardo Wise
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  2. Ramón Albarrán-Rincón
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  3. Alfonso De Lossada Juste
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  4. Ane Erkiaga Aio
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  5. Armin Klesius
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  6. Eliana Biundo
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  7. Edith Maes
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  8. Audrey Cordon
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  9. Pablo Ramos
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  10. Ignacio García-Bolao
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Corresponding author

Correspondence to Ignacio García-Bolao.

Ethics declarations

Ethics approval

The retrospective study protocol was approved by the center’s ethics committee of Clinica Universidad de Navarra, Pamplona, and the regional ethics committee.

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Not applicable.

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Conflict of interest

Ane Erkiaga Aio and Alfonso de Lossada Juste are employed by Boston Scientific. Armin Klesius was employed by Boston Scientific at the moment of the study and declare currently having no conflict of interest. Eliana Biundo, Edith Maes, and Audrey Cordon are employed by Deloitte that received an unconditional grant to conduct the research that informed this manuscript. Bernardo Wise, Ramón Albarrán-Rincón, Pablo Ramos, and Ignacio García-Bolao declare they have no financial interests.

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Wise, B., Albarrán-Rincón, R., De Lossada Juste, A. et al. Economic evaluation of an ultra-high density mapping system compared to non-ultra-high density mapping systems for radiofrequency catheter ablation procedures in patients with atrial fibrillation. J Interv Card Electrophysiol 63, 103–108 (2022). https://doi.org/10.1007/s10840-021-00951-x

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  • DOI: https://doi.org/10.1007/s10840-021-00951-x

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