DOI: 10.21045/2071-5021-2018-61-3-5

^1,2Bogachevskiy A.N., ^1,2Bogachevskaia S.A., ^1,2Bondar V.Y.
¹ Federal Center for Cardiovascular Surgery, Khabarovsk, Russia
² Far Eastern State Medical University, Khabarovsk, Russia

Contacts: Bogachevskiy Alexander, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Bogachevskiy A.N., https://orcid.org/0000-0002-5319-027X
Bogachevskaia S.A., http://orcid.org/0000-0001-7150-2620
Bondar V.Y., https://orcid.org/0000-0002-6708-9025
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interest.

Abstract

Significance. Atrial flutter is one of the most common rhythm disorders. The cost of treatment of this arrhythmia is expensive and similar to the cost of atrial fibrillation care. Effectiveness of recurrent atrial flutter catheter ablation is lower compared to the primary atrial flutter. Intraoperative visualization with intracardiac echocardiography helps to decrease the number of recurrent tachycardia. Clinical and economic analysis is relevant for high-cost methods of treatment and helps to evaluate applicability of new technologies.

Purpose: to assess clinical and economic efficiency of radiofrequency catheter ablation of recurrent atrial flutter with intracardiac echocardiography.

Methods. A prospective single-center study was performed. Results of ablation in 50 patients, operated according to the standard technique (under fluoroscopy) and with intracardiac echocardiography were analyzed. Clinical and economic analysis of the ablation outcomes was carried out using the "cost-effectiveness" method and modeling of economic cost of a five-year treatment of patients.

Results. Comparison of the cost-effectiveness ratio of the two technologies showed that technique with the intracardiac echocardiography was characterized by a higher coefficient than the standard technique. Cost of increasing the efficiency of ablation by 1% using intracardiac echocardiography added up to 19959.7 rub. Modeling of the disease cost per 100 patients per year showed that a 12.4% increase in the ablation effectiveness will reduce the cost of hospitalization and drug therapy 1.8 times in five years.

Conclusion. Intracardiac echocardiography is a highly effective method of cavotricuspi isthmus visualization ensuring better outcomes of catheter ablations. High cost of ultrasound catheters restricts their routine use in all ablations. Intracardiac echocardiography in ablations of recurrent atrial flutter is an appropriate and economically reasonable method of treatment.

Key words: clinical and economic efficiency; catheter ablation; recurrent atrial flutter; intracardiac echocardiography.

References

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