Comparison of Treatments
What Is the Clinical Impact of Catheter Ablation as Compared to AADs?
The CABANA trial found that CATHETER ABLATION was more EFFECTIVE at preventing recurrence of AF with up to 48% more patients FREE FROM ATRIAL ARRHYTHMIA over 4 years compared to drug therapy1.
CATHETER ABLATION was also associated with up to 46% reduction in the probability of AF-RELATED complications** compared to drug therapy over 7-years follow-up.1,2
The ATTEST randomized controlled trial found that patients receiving ablation, with paroxysmal AF are almost 10 TIMES LESS LIKELY TO PROGRESS TO PERSISTENT AF than those on AADs3,4
The FREQUENCY OF ADVERSE EVENTS when treating patients with CATHETER ABLATION or drug therapy IS SIMILAR however, the TYPES OF EVENTS are SPECIFIC to the TREATMENT STRATEGY.1,5,6
What Is the Economic Impact of Catheter Ablation Compared to AAD Therapy?
A UK database analysis found that catheter ablation treatment was associated with reduced resource utilization compared to drugs over 1 year.8,9
51% REDUCTION IN CARDIOVASCULAR-RELATED OUTPATIENT VISITS (p<0.001)
38% REDUCTION IN INPATIENT ADMISSIONS FOR HEART FAILURE (p=0.0318)
Several economic analyses show that RF ablation is cost effective compared to antiarrhythmic drugs due to improved clinical effectiveness over long term follow.10,11-16
Despite the initial investment, costs become favourable for catheter ablation at 5 years after the initial ablation procedure when compared to antiarrhythmic drugs.10
1. Packer DL, Mark DB, Robb RA, Monahan KH, Bahnson TD et al. (2019) Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. JAMA
2. Noseworthy PA, Gersh BJ, Kent DM, Piccini JP, Packer DL et al. (2019) Atrial fibrillation ablation in practice: assessing CABANA generalizability. Eur Heart J 40 (16): 1257-1264.
3. (HR 0.11; 95% CI 0.02-0.48; p=0.0034)n
4. Kuck KH, Lebedev, D., Mikaylov, E., Romanov, A., Geller, L., Kalejs, O., Neumann, T., Davtyan, K., On, Y.K., Popov, S., Ouyang, F. (2019) Catheter ablation delays progression of atrial fibrillation from paroxysmal to persistent atrial fibrillation. ESC Late-breaking Science 2019. Paris, France. August 31, 2019.
5. Marrouche NF, Brachmann J, Andresen D, Siebels J, Boersma L et al. (2018) Catheter Ablation for Atrial Fibrillation with Heart Failure. N Engl J Med 378 (5): 417-427.
6. Blomstrom-Lundqvist C, Gizurarson S, Schwieler J, Jensen SM, Bergfeldt L et al. (2019) Effect of Catheter Ablation vs Antiarrhythmic Medication on Quality of Life in Patients With Atrial Fibrillation: The CAPTAF Randomized Clinical Trial. JAMA 321 (11): 1059-1068.
7. Mark DB, Anstrom KJ, Sheng S, Piccini JP, Baloch KN et al. (2019) Effect of Catheter Ablation vs Medical Therapy on Quality of Life Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. JAMA
8. 1 year time frame excludes resource use during the 3 month post-ablation blanking period
9. Jarman JWE, Hussain W, Wong T, Markides V, March J et al. (2018) Resource use and clinical outcomes in patients with atrial fibrillation with ablation versus antiarrhythmic drug treatment. BMC Cardiovasc Disord 18 (1): 211
10. Weerasooriya R, Jais P, Le Heuzey JY, Scavee C, Choi KJ et al. (2003) Cost analysis of catheter ablation for paroxysmal atrial fibrillation. Pacing Clin Electrophysiol 26 (1 Pt 2): 292-294.
11. Rodgers MM, C. Palmer, S. Chambers, D. Van Hout, S. Golder, S., Pepper CT, D. Woolacott, N. (2008) Curative catheter ablation in atrial fibrillation and typical atrial flutter: systematic review and economic evaluation. Health Technol Asess 12 (34):
12. Reynolds MR, Zimetbaum P, Josephson ME, Ellis E, Danilov T et al. (2009) Cost-effectiveness of radiofrequency catheter ablation compared with antiarrhythmic drug therapy for paroxysmal atrial fibrillation. Circ Arrhythm Electrophysiol 2 (4): 362-369.
13. Assasi NB, G. Xie, F. Gaebel, K. Robertson, D. Hopkins, R. Healey, J. Roy, D. Goeree, R. (2010) Ablation Procedures for Rhythm Control in Patients with Atrial Fibrillation: Clinical and Cost-Effectiveness Analyses. Health Technology Assessment (HTA). 128
14. McKenna C, Palmer S, Rodgers M, Chambers D, Hawkins N et al. (2009) Cost-effectiveness of radiofrequency catheter ablation for the treatment of atrial fibrillation in the United Kingdom. Heart 95 (7): 542-549.
15. Khaykin Y, Wang X, Natale A, Wazni OM, Skanes AC et al. (2009) Cost comparison of ablation versus antiarrhythmic drugs as first-line therapy for atrial fibrillation: an economic evaluation of the RAAFT pilot study. J Cardiovasc Electrophysiol 20 (1): 7-12.
16. Aronsson M, Walfridsson H, Janzon M, Walfridsson U, Nielsen JC et al. (2015) The cost-effectiveness of radiofrequency catheter ablation as first-line treatment for paroxysmal atrial fibrillation: results from a MANTRA-PAF substudy. Europace 17 (1): 48-55.
17. (HR 0.11; 95% CI 0.025-0.483; p=0.0034.)
126680-191029 EMEA; 123104-200130 EMEA; 125888-191019 EMEA