THE ASSESSMENT OF CLINICAL AND ECONOMIC EFFECTIVENESS OF RADIOFREQUENCY ABLATION WITH IMPLANTED CARDIAC DEVICES IN PATIENTS WITH ATRIAL FIBRILLATION. LITERATURE REVIEW
Introduction. Atrial fibrillation (AFib) is a health condition in which irregular heartbeats are registered in the chambers of the heart. The condition is characterized by the risk of developing blood clots which may lead to stroke.
Objective. To evaluate the clinical and cost-effectiveness and safety of radiofrequency ablation (RFA) with implanted cardiac devices versus the Cox-Maze procedure (CM) in drug-resistant patients with AFib.
Search strategy. PubMed, the Cochrane Library, NICE, and CADTH Evidence Driven have been used for the literature search. Search filters: systematic reviews, meta - analyzes, randomized controlled trials (RCTs); population: humans; date of publication: 5 -20 years. To assess the quality of systematic reviews and meta-analyses, we used the AMSTAR checklist. The ELSI checklist has been applied in order to check RFA for potential ethical, social and legal aspects. The article was peer-reviewed by two independent public health professionals.
Results. The success rates of RFA varied and might be explained by AFib types and an electrophysiologist’s clinical experience. From the safety standpoint, the technology may cause rare complications (3-5%) as bleeding, thromboembolism, the pacemaker syndrome and some interactions with cardiac devices such as oversensing or transvenous lead dislodgment. From the societal implications, RFA improves patients’ recovery and allows them to be discharged from the clinic in 2-3 days so that it saves hospital resources, whereas CM requires the patients to stay in the hospital for 4 to 6 weeks.
Conclusions. RFA with implanted cardiac devices is clinically effective and generally safe for the treatment of AFib in drug-resistant patients. Also, the health technology is potentially cost - effective and resource-saving for hospitals. Nonetheless, its clinical effects and economic implications in the long turn should be further investigated.
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Салпынов Ж.Л., Гаитова K.K., Taбаров A.Б., Жолдасов З.K., Новакович T., Паркер M., Aвдеев A.В. Оценка клинической и экономической эффективности радиочастотной абляции с имплантацией сердечных устройств у пациентов с фибрилляцией предсердий. Литературный обзор // Наука и Здравоохранение. 2020. 3 (Т.22). С. 32-41. doi:10.34689/SH.2020.22.3.006Похожие публикации:
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