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Cost-Effectiveness of Radiofrequency Ablation for Supraventricular Tachycardia
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What is the problem and what is known about it so far?
Supraventricular tachycardia (SVT) is a type of abnormally fast heart rhythm that affects about 570,000 people in the United States. Although SVT is rarely life-threatening, some patients can have uncomfortable episodes of SVT many times per year that require urgent treatment. Options for treatment include drug therapy and radiofrequency ablation. Radiofrequency ablation is a procedure in which a doctor inserts a special electronic device through a small tube (catheter) inserted into a patient's vein. The doctor steers this device through the veins up to the patient's heart. Once in the heart, the device is used to heat up and destroy the section of heart tissue that is causing the SVT. In general, radiofrequency ablation is more effective than drug therapy at stopping SVT and its symptoms. However, it is expensive and carries some risk for complications.
Why did the researchers do this particular study?
To see whether radiofrequency ablation is a cost-effective option for treating patients with SVT.
Who was studied?
Rather than studying actual patients, the researchers used computers to simulate what would happen to a “virtual” group of patients who experienced an average of one SVT episode per month.
How was the study done?
The researchers used information from actual patients and from the medical literature to estimate what might happen when patients were treated using radiofrequency ablation, long-term drug therapy to prevent SVT, or drug treatment of SVT episodes as they occur. The computer model then calculated how much each strategy would cost for a given amount of benefit. The benefit was measured in units known as quality-adjusted life-years. This measure takes into consideration not only how long a person lives but also the quality of his or her life during that time.
What did the researchers find?
Among patients who have monthly episodes of SVT, radiofrequency ablation was the most effective and least expensive therapy over the long term.
What were the limitations of the study?
This study was a computer simulation, so we cannot be sure what the results would be with actual patients. However, studies of this problem using actual patients are unlikely to be done soon (if ever). In addition, this analysis did not directly address patients who have less frequent episodes of SVT.
What are the implications of the study?
In patients with frequent episodes of SVT, radiofrequency ablation substantially improves quality of life and lowers lifetime costs of SVT treatment. Radiofrequency ablation is the preferred treatment compared with episodic and long-term drug therapy.
Article and Author Information
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The summary below is from the full report titled “Cost-Effectiveness of Radiofrequency Ablation for Supraventricular Tachycardia.” It is in the 5 December 2000 issue of Annals of Internal Medicine (volume 133, pages 864-876). The authors are CHF Cheng, GD Sanders, MA Hlatky, P Heidenreich, KM McDonald, BK Lee, MS Larson, and DK Owens.
- Copyright ©2004 by the American College of Physicians
