ArticleIndian pacing and electrophysiology journal
Evaluation of technical and economic outcomes of contact force-sensing catheters for pulmonary vein isolation in symptomatic paroxysmal atrial fibrillation in a developing country.
Article in Indian pacing and electrophysiology journal. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionContact force (CF)-sensing catheters may improve lesion quality and procedural efficiency during pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (AF), but data on their clinical and economic implications in developing countries remain limited. This pilot study evaluated the technical, clinical, and economic outcomes of CF catheters compared with non-CF catheters in symptomatic paroxysmal AF.
methodsIn this pilot study conducted in Vietnam, 45 patients underwent PVI. Technical outcomes included first-pass isolation (FPI), fluoroscopy time, and lesion-related procedural measures. Clinical outcomes included acute pulmonary vein reconnection and AF recurrence at 3 months. An economic analysis was performed from the payer perspective.
resultsCF-guided PVI was associated with lower fluoroscopy time than non-CF ablation (12.19 ± 2.46 vs 14.04 ± 2.93 min, p = 0.026) and higher bilateral FPI (81.0% vs 37.5%, p = 0.003). The acute reconnection rate was 2.38% with CF and 8.33% with non-CF (p = 0.170). No procedural complications occurred in either group. At 3 months, 85.7% of patients in the CF group and 58.3% in the non-CF group were free from AF recurrence (p = 0.055). Total procedural cost was higher with CF catheters (201.08 ± 23.56 vs 191.03 ± 9.71 million VND), with an ICER of 36.7 million VND per additional patient free from AF recurrence at 3 months.
conclusionCF-guided PVI was associated with better technical performance and a possible favorable short-term clinical trend, despite higher upfront costs. Exploratory economic analysis suggested a possible short-term economic benefit, pending confirmation in larger long-term studies.
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