Table 2 Conclusions of retrieved economic evaluations on CA’s cost effectiveness

Chan et al., 2006 (US) [7]

In patients with AF, catheter ablation is unlikely to be cost-effective in patients at low risk for stroke. In moderate-risk patients, catheter ablation may be cost-effective if sufficiently high efficacy rates in restoring sinus rhythm translate into lower morbidity.

First- and second-line catheter ablation

Ollendorf et al., 2010 (US) [10]

No explicit conclusion on the intervention’s cost effectiveness is drawn.

There is only a high certainty of a small benefit for second-line ablation in paroxysmal AF patients. In other populations and for first-line ablation there is a potential but unproven benefit.

Second-line catheter ablation

Assasi et al., 2010 (Canada) [6]

The primary economic evaluation using a five-year time horizon found the incremental cost per QALY of AF ablation compared with AAD to be $59 194.

Eckard et al., 2009 (Sweden) [8]

The radiofrequency ablation treatment strategy was associated with reduced cost and an incremental gain in QALYs and was considered a cost-effective treatment strategy compared to the AAD in a lifetime perspective.

Reynolds et al., 2010 (US) [11]

Catheter ablation with/without AAD for symptomatic, drug-refractory paroxysmal AF appears to be reasonably cost-effective compared with AAD therapy alone from the perspective of the US health care system. The ICER for catheter ablation versus AAD was $51 431 per QALY applying a 5-year time horizon.

Rodgers et al., 2008 (UK) [9, 12]

The overall conclusions regarding the cost-effectiveness of catheter ablation appear to require that the QoL benefits are maintained for more than 5 years and/or that normal sinus rhythm has prognostic value in preventing the risk of stroke. If neither of these is considered to be realistic then the cost-effectiveness of catheter ablation remains highly uncertain.

McKenna et al., 2009 (UK) [9, 12]