TY  - JOUR
A1  - Chun, Kyoung-Ryul Julian
A1  - Brugada, Josep
A1  - Elvan, Arif
A1  - Gellér, László
A1  - Busch, Matthias
A1  - Barrera, Alberto
A1  - Schilling, Richard J.
A1  - Reynolds, Matthew R.
A1  - Hokanson, Robert B.
A1  - Holbrook, Reece
A1  - Brown, Benedict
A1  - Schlüter, Michael
A1  - Kuck, Karl-Heinz
T1  - The impact of cryoballoon versus radiofrequency ablation for paroxysmal atrial fibrillation on healthcare utilization and costs : an economic analysis from the fire and ice trial
T2  - Journal of the American Heart Association
N2  - Background: This study sought to assess payer costs following cryoballoon or radiofrequency current (RFC) catheter ablation of paroxysmal atrial fibrillation in the randomized FIRE AND ICE trial.
Methods and Results: A trial period analysis of healthcare costs evaluated the impact of ablation modality (cryoballoon versus RFC) on differences in resource use and associated payer costs. Analyses were based on repeat interventions, rehospitalizations, and cardioversions during the trial, with unit costs based on 3 national healthcare systems (Germany [€], the United Kingdom [£], and the United States [Embedded Image]). Total payer costs were calculated by applying standard unit costs to hospital stays, using International Classification of Diseases, 10th Revision diagnoses and procedure codes that were mapped to country‐specific diagnosis‐related groups. Patients (N=750) randomized 1:1 to cryoballoon (n=374) or RFC (n=376) ablation were followed for a mean of 1.5 years. Resource use was lower in the cryoballoon than the RFC group (205 hospitalizations and/or interventions in 122 patients versus 268 events in 154 patients). The cost differences per patient in mean total payer costs during follow‐up were €640, £364, and Embedded Image925 in favor of cryoballoon ablation (P=0.012, 0.013, and 0.016, respectively). This resulted in trial period total cost savings of €245 000, £140 000, and Embedded Image355 000.
Conclusions: When compared with RFC ablation, cryoballoon ablation was associated with a reduction in resource use and payer costs. In all 3 national healthcare systems analyzed, this reduction resulted in substantial trial period cost savings, primarily attributable to fewer repeat ablations and a reduction in cardiovascular rehospitalizations with cryoballoon ablation.
Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Identifier: NCT01490814.
KW  - atrial fibrillation
KW  - catheter ablation
KW  - cryoballoon
KW  - health economics
KW  - pulmonary vein isolation
Y1  - 2017
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/45788
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-457882
SN  - 2047-9980
N1  - Copyright & Usage: © 2017 The Authors and Medtronic. Published on behalf of the American Heart Association, Inc., by Wiley.
This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
N1  - Correction erschienen in Journal of the American Heart Association, 6.2017, Nr. 9, e002230, doi:10.1161/JAHA.117.002230
VL  - 6
IS  - 8, e006043
SP  - 1
EP  - 9
PB  - Association
CY  - New York, NY
ER  -