Cost-Effectiveness of Radiofrequency Ablation for Supraventricular Tachycardia in Guatemala
Open accessAbstract
Background Radiofrequency ablation (RFA) is an established but expensive treatment alternative for many forms supraventricular tachycardia (SVT). Currently no studies exist on the cost-effectiveness of RFA compared to medical treatment (MT) in adult Latin American population.Methods Between 2007 and 2012, we identified 103 adults who underwent RFA for SVT in the National Unit of Cardiovascular Surgery (UNICAR) in Guatemala. A decision tree was developed with all clinical outcome parameter estimates obtained from the Adult Electrophysiology Clinic. Costs were obtained from UNICAR's administration. A cost-effectiveness analysis was conducted which evaluated costs and quality adjusted life years (QALYs) to compare interventions in terms of their incremental cost-effectiveness ratios (ICERs).Results The first RFA had 83% success and cumulative 94% success was achieved with a second one. The cost of the RFA procedure itself was $5,411. RFA gains 1.46 QALYs and saves $ 7,993 compared to of MT for patients with SVT. This demonstrates that in Guatemala, RFA dominates MT in the management of SVT. Using assumptions based largely on the outcomes in UNICAR, we found that the RFA is highly cost-effective. This is a consistent finding, even after varying assumptions about efficacy, complication rates and quality of life.Conclusions RFA dominates MT by improving quality of life and reducing expenditures when used to treat severely symptomatic patients with SVT in Guatemala. The robustness of these finding to variations in parameter assumptions, suggests these findings may hold in other similar settings.
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Radiofrequency ablation was highly cost-effective (dominant) compared with medical treatment of supraventricular tachycardia in adults in Latin America (Guatemala).
“RF ablation was also found highly cost-effective ('dominant') in a comparative study vs. medical treatment of SVT of adult patients in Latin America (Guatemala) (Table 21).416”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [416]
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- Authors
- Rodriguez, B. C., Leal, S., Calvimontes, G., & Hutton, D.
- Affiliations
- Unidad de Cirugía Cardiovascular de Guatemala (GT)
- University of Michigan (US)
- Venue
- Value in Health Regional Issues
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 8
- Pages
- 92-98
- ISSN
- 2212-1099 (ISSN-L)
- PMC
- PMC4629636
- OpenAlex
- W2098150216
- Cited by
- 11
- References
- 15
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 4 · 2022: 1 · 2020: 1 · 2016: 2 · 2015: 1
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Value in Health Regional Issues (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Fogarty International Center (D43TW009315)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Keywords
- radiofrequency ablation, supraventricular tachycardia, cost-effectiveness, medical treatment, quality-adjusted life years, incremental cost-effectiveness ratio, ablation success rate, Guatemala, Latin America
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