Radiofrequency catheter ablation versus medical therapy for initial treatment of supraventricular tachycardia and its impact on quality of life and healthcare costs
Abstract
We prospectively compared the impact on quality of life and cost effectiveness between ablation and medication as an initial strategy for patients with paroxysmal supraventricular tachycardia (SVT). Seventy-nine consecutive patients with newly documented paroxysmal SVT were treated with either ablation or medication. Health surveys (SF-36 and disease-specific questions) were obtained at baseline and after 12 months of follow up. Cost of health care utilization for the 6 months before and after treatment were measured. Both medication and ablation improved quality of life. However, ablation improved quality of life in more general health categories than medication. At follow up, ablation was associated with significantly improved quality of life in the bodily pain (63+/-24 vs 81+/-20, p <0.005), general health (69+/-21 vs 79+/-21, p <0.05), vitality (55+/-21 vs 66+/-22, p <0.05), and role emotion (78+/-36 vs 94+/-17, p <0.05) categories when compared with medication. Although both medication and ablation decreased frequency of disease-specific symptoms, ablation resulted in complete amelioration of symptoms in more patients (33% vs 74%). Potential long-term costs were similar for medication and ablation. In conclusion, ablation improves health-related quality of life to a greater extent, and in more aspects of general and disease-specific health than medication.
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Costs of radiofrequency catheter ablation procedures vary from $5000 to $16000, varying by setting, country, and whether actual costs or billed hospital charges are considered.
“With regard to the costs of radiofrequency catheter ablation procedures, variable data have been reported in literature (from $5000 to $16 000), varying not only according to setting and country but also according to consideration of actual costs or billed hospital charges.258”
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 [258]
In patients with symptoms controlled by medications, the upfront cost of ablation therapy is equalled over time by cumulative medical therapy, usually after around 10 years.
“In patients with symptoms that can be controlled with medications, the upfront cost of ablation therapy is equalled, with time, by the cumulative cost of medical therapy, usually after a period of around 10 years.258”
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 [258]
Every study has demonstrated an improvement in self-reported quality of life following ablation.
“Every study has demonstrated an improvement in self-reported QoL following ablation.2,245,246,254 -256,258,424,425”
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 [258]
Almost all studies examining quality of life with validated questionnaires have been conducted in patients undergoing catheter ablation for supraventricular tachycardia, often without a comparison group.
“Almost all of the studies examining QoL, measured with validated questionnaires, have been conducted in patients undergoing catheter ablation for SVT, 245,246,254 - 256,258,424,425 although often without a comparison group.”
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 [258]
Several studies have investigated patient-reported quality of life and may offer some insight into patient preferences where particular therapies result in improvements in quality of life.
“Several studies have investigated patient-reported QoL, 2,245,246,254 -256,258,424,425 and these may offer some insight into patient preferences for treatment where particular therapies result in improvements in QoL.”
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 [258]
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- Authors
- Bathina, M., Mickelsen, S., Brooks, C., Jaramillo, J., Hepton, T., & Kusumoto, F.
- Affiliations
- Lovelace Medical Center (US)
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 1998-09
- Volume
- 82
- Issue
- 5
- Pages
- 589-593
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2053154502
- Cited by
- 109
- References
- 12
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2022: 2 · 2021: 7 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 5 · 2015: 9 · 2014: 3 · 2013: 4 · 2012: 6
- FWCI
- 3.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- paroxysmal supraventricular tachycardia, radiofrequency catheter ablation, antiarrhythmic drugs, quality of life, cost-effectiveness, health care costs, SF-36, symptom burden, initial treatment strategy
- MeSH terms
- Activities of Daily Living, Adult, Aged, Anti-Arrhythmia Agents, Cost-Benefit Analysis, Female, Follow-Up Studies, Humans, Male, Middle Aged, New Mexico, Quality of Life, Tachycardia, Paroxysmal, Tachycardia, Supraventricular, Treatment Outcome, Health Care Costs, Patient Satisfaction, Catheter Ablation
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