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An Economic Analysis of the Systematic Use of Mapping Systems during Catheter Ablation Procedures: Single Center Experience

INTRODUCTION: In this study we estimated the cost-effectiveness of adopting 3D Nonfluoroscopic Mapping Systems (NMSs) for catheter ablation (CA). METHODS: This study includes patients who underwent supraventricular tachycardia (SVT) CA and atrial fibrillation (AF) CA from 2007 to 2016. A comparison...

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Autores principales: Marini, Massimiliano, Ravanelli, Daniele, Martin, Marta, Del Greco, Maurizio, Guarracini, Fabrizio, Quintarelli, Silvia, Coser, Alessio, Valentini, Aldo, Bonmassari, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6720348/
https://www.ncbi.nlm.nih.gov/pubmed/31531347
http://dx.doi.org/10.1155/2019/2427015
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author Marini, Massimiliano
Ravanelli, Daniele
Martin, Marta
Del Greco, Maurizio
Guarracini, Fabrizio
Quintarelli, Silvia
Coser, Alessio
Valentini, Aldo
Bonmassari, Roberto
author_facet Marini, Massimiliano
Ravanelli, Daniele
Martin, Marta
Del Greco, Maurizio
Guarracini, Fabrizio
Quintarelli, Silvia
Coser, Alessio
Valentini, Aldo
Bonmassari, Roberto
author_sort Marini, Massimiliano
collection PubMed
description INTRODUCTION: In this study we estimated the cost-effectiveness of adopting 3D Nonfluoroscopic Mapping Systems (NMSs) for catheter ablation (CA). METHODS: This study includes patients who underwent supraventricular tachycardia (SVT) CA and atrial fibrillation (AF) CA from 2007 to 2016. A comparison was conducted between a reference year (2007) and the respective years for the two types of procedure in which the maximum optimization of patients' exposure using NMSs was obtained. We compared the data of all SVT CA performed solely using fluoroscopy in 2007 (Group I) and all SVT CA procedures performed using fluoroscopy together with an NMS in 2011 (Group II). There was also an important comparison made between AF CA procedures performed in 2007 (Group III) and AF CA in 2012 (Group IV), where patients' treatment in both years included the use of an NMS but where the software and hardware versions of the NMS were different. Two cost-effectiveness analyses were carried out. The first method was based on the alpha value (AV): the AV is a monetary reference value of avoided unit of exposure and is expressed as $/mansievert. The second one was based on the value of a statistical life (VSL): the VSL does not represent the cost value of a person's life, but the amount that a community would be willing to pay to reduce the risk of a person's death. The costs estimated from these two methods were compared to the real additional cost of using an NMS during that type of procedure in our EP Lab. RESULTS: The use of NMS reduced the effective dose of about 2.3 mSv for SVT and 23.8 mSv for AF CA procedures. The use of NMS, applying directly AV or VSL values, was not cost-effective for SVT CA for the most countries, whereas the use of an NMS during an AF CA seemed to be cost-effective for most of them. CONCLUSIONS: In our analysis the cost-effectiveness of the systematic use of NMSs strongly depended on the AV and VSL values considered. Nonetheless, the approach seemed to be cost-effective only during AF CA procedures.
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spelling pubmed-67203482019-09-17 An Economic Analysis of the Systematic Use of Mapping Systems during Catheter Ablation Procedures: Single Center Experience Marini, Massimiliano Ravanelli, Daniele Martin, Marta Del Greco, Maurizio Guarracini, Fabrizio Quintarelli, Silvia Coser, Alessio Valentini, Aldo Bonmassari, Roberto Biomed Res Int Research Article INTRODUCTION: In this study we estimated the cost-effectiveness of adopting 3D Nonfluoroscopic Mapping Systems (NMSs) for catheter ablation (CA). METHODS: This study includes patients who underwent supraventricular tachycardia (SVT) CA and atrial fibrillation (AF) CA from 2007 to 2016. A comparison was conducted between a reference year (2007) and the respective years for the two types of procedure in which the maximum optimization of patients' exposure using NMSs was obtained. We compared the data of all SVT CA performed solely using fluoroscopy in 2007 (Group I) and all SVT CA procedures performed using fluoroscopy together with an NMS in 2011 (Group II). There was also an important comparison made between AF CA procedures performed in 2007 (Group III) and AF CA in 2012 (Group IV), where patients' treatment in both years included the use of an NMS but where the software and hardware versions of the NMS were different. Two cost-effectiveness analyses were carried out. The first method was based on the alpha value (AV): the AV is a monetary reference value of avoided unit of exposure and is expressed as $/mansievert. The second one was based on the value of a statistical life (VSL): the VSL does not represent the cost value of a person's life, but the amount that a community would be willing to pay to reduce the risk of a person's death. The costs estimated from these two methods were compared to the real additional cost of using an NMS during that type of procedure in our EP Lab. RESULTS: The use of NMS reduced the effective dose of about 2.3 mSv for SVT and 23.8 mSv for AF CA procedures. The use of NMS, applying directly AV or VSL values, was not cost-effective for SVT CA for the most countries, whereas the use of an NMS during an AF CA seemed to be cost-effective for most of them. CONCLUSIONS: In our analysis the cost-effectiveness of the systematic use of NMSs strongly depended on the AV and VSL values considered. Nonetheless, the approach seemed to be cost-effective only during AF CA procedures. Hindawi 2019-08-20 /pmc/articles/PMC6720348/ /pubmed/31531347 http://dx.doi.org/10.1155/2019/2427015 Text en Copyright © 2019 Massimiliano Marini et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Marini, Massimiliano
Ravanelli, Daniele
Martin, Marta
Del Greco, Maurizio
Guarracini, Fabrizio
Quintarelli, Silvia
Coser, Alessio
Valentini, Aldo
Bonmassari, Roberto
An Economic Analysis of the Systematic Use of Mapping Systems during Catheter Ablation Procedures: Single Center Experience
title An Economic Analysis of the Systematic Use of Mapping Systems during Catheter Ablation Procedures: Single Center Experience
title_full An Economic Analysis of the Systematic Use of Mapping Systems during Catheter Ablation Procedures: Single Center Experience
title_fullStr An Economic Analysis of the Systematic Use of Mapping Systems during Catheter Ablation Procedures: Single Center Experience
title_full_unstemmed An Economic Analysis of the Systematic Use of Mapping Systems during Catheter Ablation Procedures: Single Center Experience
title_short An Economic Analysis of the Systematic Use of Mapping Systems during Catheter Ablation Procedures: Single Center Experience
title_sort economic analysis of the systematic use of mapping systems during catheter ablation procedures: single center experience
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6720348/
https://www.ncbi.nlm.nih.gov/pubmed/31531347
http://dx.doi.org/10.1155/2019/2427015
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