ArticlePharmacoEconomics2026
The Cost Utility of Rhythm Control Treatment Sequences in Patients with Atrial Fibrillation: Anti-arrhythmic Drugs Versus Catheter Ablation.
Article in PharmacoEconomics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- PulseSelect vs FARAPULSE pulsed field ablation: Comparative analysis of myocardial, neural-injury and hemolysis biomarkers and short-term outcomes.International journal of cardiology. Heart & vasculature · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveDespite evidence on the cost effectiveness of catheter ablation (CA) as a rhythm control strategy in patients with atrial fibrillation, CAs form a substantial share of medical resource consumption, raising questions about optimal timing and maximum CAs per patient. This study addresses these questions using a newly developed open source model integrating observational and clinical trial data. The objective was to estimate the cost effectiveness of rhythm control strategies including anti-arrhythmic drugs (AADs) and/or CA in different sequences from a societal perspective in the Netherlands.
methodsTime to atrial fibrillation symptom recurrence after a CA was estimated using parametric survival functions estimated on health insurance data (n = 24,286). Relative efficacy of CAs versus AADs was derived from meta-analyses, accounting for previous treatment exposure. Six treatment lines were modeled, incorporating AADs and CAs as rhythm control strategies. Medical and societal costs were included and the model had a lifetime time horizon. Model results were generated in 2024 Euros using Dutch input data with a cost-per-quality-adjusted life-year threshold of €20,000. For the probabilistic sensitivity analyses, we simultaneously varied all parameters across 1000 model runs with 5000 patients each.
resultsTreatment sequences including at least one CA were cost effective compared with only AADs. Catheter ablation costs are counterbalanced by reduced medical resource consumption in the years following CA. 51.6% of patients with first-line CA remain symptom free over a lifetime versus 6.9% with AADs. The most cost-effective strategy starts with CA, manages atrial fibrillation recurrences with AADs, and uses a maximum of three repeat ablations.
conclusionsOur model suggests that rhythm control with at least one CA is cost effective compared with only AADs in patients with atrial fibrillation requiring rhythm control. Within shared decision making, first-line CA, followed by AADs to manage atrial fibrillation recurrences, with a maximum of three repeat ablations, represents the most cost-effective strategy for patients with symptomatic atrial fibrillation requiring rhythm control.
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