Cost-effectiveness of radiofrequency catheter ablation for the treatment of atrial fibrillation in the United Kingdom

C McKenna, Stephen John Palmer, M Rodgers, D Chambers, N Hawkins, S Golder, S Van Hout, C Pepper, D Todd, N Woolacott

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: To assess the cost-effectiveness of radiofrequency catheter ablation (RFCA) compared with anti-arrhythmic drug (AAD) therapy for the treatment of atrial fibrillation (AF) from the perspective of the UK NHS.

DESIGN: Bayesian evidence synthesis and decision analytical model.

METHODS: A systematic review and meta-analysis was conducted and Bayesian statistical methods used to synthesise the effectiveness evidence from randomised control trials. A decision analytical model was developed to assess the costs and consequences associated with the primary outcome of the trials over a lifetime time horizon.

MAIN OUTCOME MEASURE: Costs from a health service perspective and outcomes measured as quality-adjusted life years (QALYs).

RESULTS: The incremental cost-effectiveness ratio of RFCA varied between pound7763 and pound7910 for each additional QALY according to baseline risk of stroke, with a probability of being cost-effective from 0.98 to 0.99 for a cost-effectiveness threshold of pound20 000. Results were sensitive to the duration of quality of life benefits from treatment.

CONCLUSIONS: RFCA is potentially cost-effective for the treatment of paroxysmal AF in patients' predominantly refractory to AAD therapy provided the quality-of-life benefits from treatment are maintained for more than 5 years. These findings remain subject to limitations in the existing evidence regarding the nature of life benefits and the prognostic importance of restoring normal sinus rhythm conferred using RFCA.

Original languageEnglish
Pages (from-to)542-9
Number of pages8
Issue number7
Publication statusPublished - Apr 2009


  • Anti-Arrhythmia Agents
  • Atrial Fibrillation
  • Bayes Theorem
  • Catheter Ablation
  • Cost-Benefit Analysis
  • Drug Costs
  • Great Britain
  • Humans
  • Quality-Adjusted Life Years
  • Stroke
  • Treatment Outcome

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