Authors' recommendations: The evidence in this systematic review indicates that the use of catheter ablation increases the rate of maintenance of sinus rhythm compared with treatment with AADs in patients for whomthe use of one or two drugs failed. The studies are of insufficient size and duration to evaluate the impact on stroke, heart failure, and mortality. Ablation techniques were shown to lead to better results in patients with paroxysmal AF. Limited data suggest that catheter ablation may be an effective first-line rhythm control strategy in patients with AF. More trials are needed toconfirm these findings. Our review suggests that patients with persistent AF may benefit more from PVI+ strategies than from PVI.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. These findings were similar to thoseof other published economic evaluations. The cost-effectiveness of AF ablation was found to be more favourable when longer time horizons were used.

Project Status: Completed

URL for project: http://www.cadth.ca/media/pdf/H0491_Ablation_Procedures_with_Atrial_Fibrillation_tr_e.pdf

Year Published: 2010

URL for published report: http://www.cadth.ca/index.php/en/hta/reports-publications/search/publication/2663

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Agency for Drugs and Technologies in Health

Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;

Contact Name: requests@cadth.ca

Contact Email: requests@cadth.ca

Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)