Kyoung-Ryul Julian Chun, Josep Brugada, Arif Elvan, László Gellér, Matthias Busch, Alberto Barrera, Richard J. Schilling, Matthew R. Reynolds, Robert B. Hokanson, Reece Holbrook, Benedict Brown, Michael Schlüter, Karl-Heinz Kuck
- 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.
MetadatenAuthor: | Kyoung-Ryul Julian ChunORCiDGND, Josep Brugada, Arif Elvan, László Gellér, Matthias Busch, Alberto Barrera, Richard J. Schilling, Matthew R. Reynolds, Robert B. Hokanson, Reece Holbrook, Benedict Brown, Michael Schlüter, Karl-Heinz Kuck |
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URN: | urn:nbn:de:hebis:30:3-457882 |
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DOI: | https://doi.org/10.1161/JAHA.117.006043 |
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ISSN: | 2047-9980 |
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Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/28751544 |
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Parent Title (English): | Journal of the American Heart Association |
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Publisher: | Association |
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Place of publication: | New York, NY |
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Document Type: | Article |
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Language: | English |
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Year of Completion: | 2017 |
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Date of first Publication: | 2017/07/27 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Contributing Corporation: | FIRE AND ICE Investigators |
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Release Date: | 2018/03/01 |
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Tag: | atrial fibrillation; catheter ablation; cryoballoon; health economics; pulmonary vein isolation |
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Volume: | 6 |
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Issue: | 8, e006043 |
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Page Number: | 11 |
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First Page: | 1 |
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Last Page: | 9 |
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Note: | 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. |
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Note: | Correction erschienen in Journal of the American Heart Association, 6.2017, Nr. 9, e002230, doi:10.1161/JAHA.117.002230 |
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HeBIS-PPN: | 432788158 |
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Institutes: | Medizin / Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (English): | Creative Commons - Namensnennung-Nicht kommerziell 4.0 |
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