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. 2014 Nov 29;3(3):177–183. doi: 10.15420/aer.2014.3.3.177

Table 2: Summary of Study Results.

Chan et al.30 Rodgers/McKenna31 Reynolds et al.(2009)21 Eckard et al.33 Assasi/ Blackhouse et al.34 Ollendorf et al.36 First-line) Reynolds et al.(2014)38 Aronsson et al.37
55 y.o. mod risk 65 y.o. mod risk 65 y.o. low risk 5-year horizon Lifetime horizon 5-year horizon 20-year horizon 60 y.o. low risk 65 y.o. mod risk 75 y.o. high risk Cryoballoon ≤50 y.o. >50 y.o.
QALYs
AF Ablation 14.26 11.06 11.40 11.18 12.14 3.51 9.46 3.42 -- 11.63 8.96 6.00 3.57 -- --
Comparison 13.95 10.81 11.21 10.76 10.77 3.38 8.68 3.27 -- 11.12 8.67 5.80 3.40 -- --
Incremental 0.31 0.25 0.19 0.42 1.37 0.13 0.78 0.14 0.51 0.51 0.30 0.21 0.17 0.142 0.035
Cost
AF Ablation $59,380 $52,369 $43,036 £26,016 £26,027 $26,584 $9,860 $21,150 CAD -- $34,044 $38,245 $34,410 £21,162 -- --
Comparison $50,509 $39,391 $24,540 £15,352 £15,367 $19,898 $1,640 (annual) $12,611 CAD -- $20,265 $20,332 $17,759 £17,627 -- --
Incremental $8,871 $12,978 $18,496 £10,664 £10,660 $6,686 $1,660 (5-year) $8,539 CAD $71 CAD $13,779 $17,913 $16,651 £3,535 €488 €3,685
ICER
Ablation vs. Comparator $28,700 /QALY $51,800 /QALY $98,900 /QALY £25,510 /QALY £7,780 /QALY $51,431/ QALY Dominant $59,194 CAD/QALY Dominant $26,869 /QALY $60,804 /QALY $80,615 /QALY £21,957/QALY €3,434 /QALY €108,937 /QALY
Probability of Cost- Effectiveness of AF Ablation at Willingness-to-pay Threshhold $50,000/QALY: 40 % $100,000/QALY: 78 % £20,000/QALY: 16.5 % £30,000/QALY: 68.6 % N/A N/A $50,000 CAD /QALY: 30 % $100,000 CAD/QALY: 89 % Multiple £20,000/QALY: unlikely £30,000/QALY: 86 % £40,000/QALY: 97.2 % <€50,000/QALY: ~90 % for ≤50 y.o. group.

AF = atrial fibrillation, AAD = anti-arrhythmic drug, RC = rate control, ASA = aspirin, NSR = normal sinus rhythm, y.o. = year old, mod = modera te, CAD = Canadian dollar, ICER = incremental cost-effectiveness ratio, QALY = quality-adjusted life year