PT - JOURNAL ARTICLE AU - McKenna, C AU - Palmer, S AU - Rodgers, M AU - Chambers, D AU - Hawkins, N AU - Golder, S AU - Van Hout, S AU - Pepper, C AU - Todd, D AU - Woolacott, N TI - Cost-effectiveness of radiofrequency catheter ablation for the treatment of atrial fibrillation in the United Kingdom AID - 10.1136/hrt.2008.147165 DP - 2009 Apr 01 TA - Heart PG - 542--549 VI - 95 IP - 7 4099 - http://heart.bmj.com/content/95/7/542.short 4100 - http://heart.bmj.com/content/95/7/542.full SO - Heart2009 Apr 01; 95 AB - 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 £7763 and £7910 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 £20 000. 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.