Cargando…

A comparative analysis of clinical outcomes and disposable costs of different catheter ablation methods for the treatment of atrioventricular nodal reentrant tachycardia

BACKGROUND: Catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT) is a commonly performed electrophysiology (EP) procedure. Few data exist comparing conventional (CONV) versus novel ablation strategies from both clinical and direct cost perspectives. We sought to investigate the...

Descripción completa

Detalles Bibliográficos
Autores principales: Berman, Adam E, Rivner, Harold, Chalkley, Robin, Heboyan, Vahé
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680894/
https://www.ncbi.nlm.nih.gov/pubmed/29138585
http://dx.doi.org/10.2147/CEOR.S139861
_version_ 1783277850097352704
author Berman, Adam E
Rivner, Harold
Chalkley, Robin
Heboyan, Vahé
author_facet Berman, Adam E
Rivner, Harold
Chalkley, Robin
Heboyan, Vahé
author_sort Berman, Adam E
collection PubMed
description BACKGROUND: Catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT) is a commonly performed electrophysiology (EP) procedure. Few data exist comparing conventional (CONV) versus novel ablation strategies from both clinical and direct cost perspectives. We sought to investigate the disposable costs and clinical outcomes associated with three different ablation methodologies used in the ablation of AVNRT. METHODS: We performed a retrospective review of AVNRT ablations performed at Augusta University Medical Center from 2006 to 2014. A total of 183 patients were identified. Three different ablation techniques were compared: CONV manual radiofrequency (RF) (n=60), remote magnetic navigation (RMN)-guided RF (n=67), and cryoablation (CRYO) (n=56). RESULTS: Baseline demographics did not differ between the three groups except for a higher prevalence of cardiomyopathy in the RMN group (p<0.01). The clinical end point of interest was recurrent AVNRT following the index ablation procedure. A significantly higher number of recurrent AVNRT cases occurred in the CRYO group as compared to CONV and RMN (p=0.003; OR =7.75) groups. Cost-benefit analysis showed both CONV and RMN to be dominant compared to CRYO. Cost-minimization analysis demonstrated the least expensive ablation method to be CONV (mean disposable catheter cost = CONV US$2340; CRYO US$3515; RMN US$5190). Despite comparable clinical outcomes, the incremental cost of RMN over CONV averaged US$3094 per procedure. CONCLUSION: AVNRT ablation using either CONV or RMN techniques is equally effective and associated with lower AVNRT recurrence rates than CRYO. CONV ablation carries significant disposable cost savings as compared to RMN, despite similar efficacy.
format Online
Article
Text
id pubmed-5680894
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-56808942017-11-14 A comparative analysis of clinical outcomes and disposable costs of different catheter ablation methods for the treatment of atrioventricular nodal reentrant tachycardia Berman, Adam E Rivner, Harold Chalkley, Robin Heboyan, Vahé Clinicoecon Outcomes Res Original Research BACKGROUND: Catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT) is a commonly performed electrophysiology (EP) procedure. Few data exist comparing conventional (CONV) versus novel ablation strategies from both clinical and direct cost perspectives. We sought to investigate the disposable costs and clinical outcomes associated with three different ablation methodologies used in the ablation of AVNRT. METHODS: We performed a retrospective review of AVNRT ablations performed at Augusta University Medical Center from 2006 to 2014. A total of 183 patients were identified. Three different ablation techniques were compared: CONV manual radiofrequency (RF) (n=60), remote magnetic navigation (RMN)-guided RF (n=67), and cryoablation (CRYO) (n=56). RESULTS: Baseline demographics did not differ between the three groups except for a higher prevalence of cardiomyopathy in the RMN group (p<0.01). The clinical end point of interest was recurrent AVNRT following the index ablation procedure. A significantly higher number of recurrent AVNRT cases occurred in the CRYO group as compared to CONV and RMN (p=0.003; OR =7.75) groups. Cost-benefit analysis showed both CONV and RMN to be dominant compared to CRYO. Cost-minimization analysis demonstrated the least expensive ablation method to be CONV (mean disposable catheter cost = CONV US$2340; CRYO US$3515; RMN US$5190). Despite comparable clinical outcomes, the incremental cost of RMN over CONV averaged US$3094 per procedure. CONCLUSION: AVNRT ablation using either CONV or RMN techniques is equally effective and associated with lower AVNRT recurrence rates than CRYO. CONV ablation carries significant disposable cost savings as compared to RMN, despite similar efficacy. Dove Medical Press 2017-11-06 /pmc/articles/PMC5680894/ /pubmed/29138585 http://dx.doi.org/10.2147/CEOR.S139861 Text en © 2017 Berman et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Berman, Adam E
Rivner, Harold
Chalkley, Robin
Heboyan, Vahé
A comparative analysis of clinical outcomes and disposable costs of different catheter ablation methods for the treatment of atrioventricular nodal reentrant tachycardia
title A comparative analysis of clinical outcomes and disposable costs of different catheter ablation methods for the treatment of atrioventricular nodal reentrant tachycardia
title_full A comparative analysis of clinical outcomes and disposable costs of different catheter ablation methods for the treatment of atrioventricular nodal reentrant tachycardia
title_fullStr A comparative analysis of clinical outcomes and disposable costs of different catheter ablation methods for the treatment of atrioventricular nodal reentrant tachycardia
title_full_unstemmed A comparative analysis of clinical outcomes and disposable costs of different catheter ablation methods for the treatment of atrioventricular nodal reentrant tachycardia
title_short A comparative analysis of clinical outcomes and disposable costs of different catheter ablation methods for the treatment of atrioventricular nodal reentrant tachycardia
title_sort comparative analysis of clinical outcomes and disposable costs of different catheter ablation methods for the treatment of atrioventricular nodal reentrant tachycardia
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680894/
https://www.ncbi.nlm.nih.gov/pubmed/29138585
http://dx.doi.org/10.2147/CEOR.S139861
work_keys_str_mv AT bermanadame acomparativeanalysisofclinicaloutcomesanddisposablecostsofdifferentcatheterablationmethodsforthetreatmentofatrioventricularnodalreentranttachycardia
AT rivnerharold acomparativeanalysisofclinicaloutcomesanddisposablecostsofdifferentcatheterablationmethodsforthetreatmentofatrioventricularnodalreentranttachycardia
AT chalkleyrobin acomparativeanalysisofclinicaloutcomesanddisposablecostsofdifferentcatheterablationmethodsforthetreatmentofatrioventricularnodalreentranttachycardia
AT heboyanvahe acomparativeanalysisofclinicaloutcomesanddisposablecostsofdifferentcatheterablationmethodsforthetreatmentofatrioventricularnodalreentranttachycardia
AT bermanadame comparativeanalysisofclinicaloutcomesanddisposablecostsofdifferentcatheterablationmethodsforthetreatmentofatrioventricularnodalreentranttachycardia
AT rivnerharold comparativeanalysisofclinicaloutcomesanddisposablecostsofdifferentcatheterablationmethodsforthetreatmentofatrioventricularnodalreentranttachycardia
AT chalkleyrobin comparativeanalysisofclinicaloutcomesanddisposablecostsofdifferentcatheterablationmethodsforthetreatmentofatrioventricularnodalreentranttachycardia
AT heboyanvahe comparativeanalysisofclinicaloutcomesanddisposablecostsofdifferentcatheterablationmethodsforthetreatmentofatrioventricularnodalreentranttachycardia