2000 effectiveness of RFA w/ pts w/ 4.6 Estimated population: PSVT, RFA most effective reduces costs when treating highly (60) medical management of unscheduled AVNRT: 65% Outcomes: costs (office visit, annual drug rx, and least expensive symptomatic pts. PSVT visits/y for AVRT w/ concealed AP: EP study, RFA, PPM, PPM replacement) option arrhythmia while 30% QALY Effects in less symptomatic not on long-term Life-years RFA reduced lifetime studies drug therapy Efficacy estimates: Marginal cost-effectiveness ratios medical expenditures by AVNRT: 97% $27,940 compared w/ AVRT w/ concealed AP: long-term pharmacologic 93% therapy Recurrence estimates: Lifetime costs: AVNRT: 5% RFA: AVRT w/ concealed AP: $61,880 8% Long-term drug rx: $89,820 Drug efficacy: 60% Episodic drug rx: $143,530 RFA improved adjusted life expectancy by 3.10 QALYs. Scheinman MM Prospective cohort study 3,357 Ablation of AVNRT, AP, Efficacy and safety of RFA w/ long-term f/u. AVNRT Large series reporting success of 2000 (NASPE registry) AVJ, atrial flutter, AT, IST, Success: 96.1% RFA, and stratification by age (61) VT, idiopathic VT Complications: 2% group confirms safety and efficacy in elderly pts, as well as by type of AVNRT (n=1,197 [35.6%) AVJ: facility (teaching vs. community). AVJ (n=646) Success: 96% AP (n=654) Complications: 25 pts AT (n=216) Recurrence:3.5% Atrial flutter (n=447) IST (n=40) AP: Success: 94-96% Complications: 31 pts total Recurrence: 4.6% AT: Success: 51-79% Complications:5 total Recurrence:15.2% Atrial flutter: Success: 86% Complications:12 pts Recurrence:14.7% IST: Success: 71%
2000 (60) effectiveness of RFA w/ medical management of PSVT pts w/ 4.6 unscheduled visits/y for arrhythmia while on long-term drug therapy Estimated population: AVNRT: 65% AVRT w/ concealed AP: 30% Efficacy estimates: AVNRT: 97% AVRT w/ concealed AP: 93% Recurrence estimates: AVNRT: 5% AVRT w/ concealed AP: 8% Drug efficacy: 60% Outcomes: costs (office visit, annual drug rx, EP study, RFA, PPM, PPM replacement) QALY Life-years Marginal cost-effectiveness ratios PSVT, RFA most effective and least expensive option RFA reduced lifetime medical expenditures by $27,940 compared w/ long-term pharmacologic therapy Lifetime costs: RFA: $61,880 Long-term drug rx: $89,820 Episodic drug rx: $143,530 RFA improved life expectancy by 3.10 QALYs. reduces costs when treating highly symptomatic pts. Effects in less symptomatic not studies Scheinman MM 2000 (61) Prospective cohort study (NASPE registry) 3,357 Ablation of AVNRT, AP, AVJ, atrial flutter, AT, IST, VT, idiopathic VT AVNRT (n=1,197 [35.6%) AVJ (n=646) AP (n=654) AT (n=216) Atrial flutter (n=447) IST (n=40) Efficacy and safety of RFA w/ long-term f/u. AVNRT Success: 96.1% Complications: 2% AVJ: Success: 96% Complications: 25 pts Recurrence:3.5% AP: Success: 94-96% Complications: 31 pts total Recurrence: 4.6% AT: Success: 51-79% Complications:5 total Recurrence:15.2% Atrial flutter: Success: 86% Complications:12 pts Recurrence:14.7% IST: Success: 71% Large series reporting success of RFA, and stratification by age group confirms safety and efficacy in elderly pts, as well as by type of facility (teaching vs. community). adjusted
2015_SVT_Evidence_Tables_Data_Supplement.docx