Patient's age rather than severity of the arrhythmia influences the cost of medical treatment of atrioventricular nodal or atrioventricular reciprocating tachycardia

Michal M Farkowski, Mariusz Pytkowski, Aleksander Maciag, Dominik Golicki, Ilona Kowalik, Marcin Czech, Piotr Rucinski, Hanna Szwed, Michal M Farkowski, Mariusz Pytkowski, Aleksander Maciag, Dominik Golicki, Ilona Kowalik, Marcin Czech, Piotr Rucinski, Hanna Szwed

Abstract

Purpose: Radiofrequency ablation (RFA) is considered the treatment of choice in cases of atrioventricular nodal reciprocating tachycardia (AVNRT) and atrioventricular reciprocating tachycardia (AVRT). Published studies suggest a considerable time gap between the onset of the arrhythmia, correct diagnosis, and RFA which may reach 10-15 years. The cost of medical treatment during that period may be substantial. The aim of the study was to calculate the annual direct medical cost of medical treatment of patients with AVNRT and AVRT and identify potential factors influencing this cost.

Methods: Based on the consumption of particular resources and the unit costs of services in 2013, we calculated the annual direct medical cost of care for patients with AVNRT and AVRT in Poland. We adopted the public payer's and societal perspectives. Data on health resources was collected with a structured questionnaire and medical records of patients scheduled for RFA. Additional analyses were performed to identify factors influencing this cost.

Results: We enrolled 82 patients: mean age 43.9 ± 14.1 years old and mean symptom duration before the RFA 13.0 ± 11.3 years. The median annual cost of medical treatment was 546 USD [312-957], 411 € [278-786], and 616 USD [369-1044], 464 € [235-721], for the public payer and the common perspective, respectively, with hospitalizations being the main cost component. In multivariate analysis, only the age of the patient significantly influenced this cost.

Conclusions: The annual cost of medical treatment of AVNRT or AVRT is substantial and dependent on the age of the patient rather than the severity of the arrhythmia (NCT01594814).

Keywords: AVNRT; AVRT; Cost; Medical treatment.

Conflict of interest statement

Compliance with ethical standards The study protocol was approved by the local Institutional Review Board and was in full compliance with the Declaration of Helsinki. Source of funding The study received support from the Institute of Cardiology, Warsaw, Poland, research grant 2.16/IV/12. Conflict of interest The authors declare that they have no conflict of interest.

References

    1. Goldberg AS, Bathina MN, Mickelsen S, Nawman R, West G, Kusumoto FM. Long-term outcomes on quality-of-life and health care costs in patients with supraventricular tachycardia (radiofrequency catheter ablation versus medical therapy) Am J Cardiol. 2002;89(9):1120–3. doi: 10.1016/S0002-9149(02)02285-3.
    1. Walfridsson U, Stromberg A, Janzon M, Walfridsson H. Wolff-Parkinson-White syndrome and atrioventricular nodal re-entry tachycardia in a Swedish population: consequences on health-related quality of life. Pacing Clin Electrophysiol. 2009;32(10):1299–306. doi: 10.1111/j.1540-8159.2009.02476.x.
    1. Yildirim O, Yontar OC, Semiz M, Erdem A, Canan F, Yontar G, et al. The effect of radiofrequency ablation treatment on quality of life and anxiety in patients with supraventricular tachycardia. Eur Rev Med Pharmacol Sci. 2012;16(15):2108–12.
    1. Blomstrom-Lundqvist C, Scheinman MM, Aliot EM, Alpert JS, Calkins H, Camm AJ, et al. ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias—executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients with Supraventricular Arrhythmias) developed in collaboration with NASPE-Heart Rhythm Society. J Am Coll Cardiol. 2003;42(8):1493–531. doi: 10.1016/j.jacc.2003.08.013.
    1. Dagres N, Clague JR, Breithardt G, Borggrefe M. Significant gender-related differences in radiofrequency catheter ablation therapy. J Am Coll Cardiol. 2003;42(6):1103–7. doi: 10.1016/S0735-1097(03)00925-2.
    1. Deneke T, Mugge A, Muller P, de Groot JR. Therapeutic implications of gender differences in supraventricular cardiac arrhythmias: lessons of life cannot be learned in a day. Expert Rev Cardiovasc Ther. 2009;7(8):879–82. doi: 10.1586/erc.09.80.
    1. Spector P, Reynolds MR, Calkins H, Sondhi M, Xu Y, Martin A, et al. Meta-analysis of ablation of atrial flutter and supraventricular tachycardia. Am J Cardiol. 2009;104(5):671–7. doi: 10.1016/j.amjcard.2009.04.040.
    1. Raatikainen MJ, Arnar DO, Zeppenfeld K, Merino JL, Kuck KH, Hindricks G. Current trends in the use of cardiac implantable electronic devices and interventional electrophysiological procedures in the European Society of Cardiology member countries: 2015 report from the European Heart Rhythm Association. Europace. 2015;17(Suppl 4):iv1–72. doi: 10.1093/europace/euv265.
    1. Farkowski MM, Pytkowski M, Maciag A, Golicki D, Wood KA, Kowalik I, et al. Gender-related differences in outcomes and resource utilization in patients undergoing radiofrequency ablation of supraventricular tachycardia: results from Patients’ Perspective on Radiofrequency Catheter Ablation of AVRT and AVNRT Study. Europace. 2014;16(12):1821–7. doi: 10.1093/europace/euu130.
    1. Wood KA, Wiener CL, Kayser-Jones J. Supraventricular tachycardia and the struggle to be believed. Eur J Cardiovasc Nurs. 2007;6(4):293–302. doi: 10.1016/j.ejcnurse.2007.02.006.
    1. Farkowski MM, Pytkowski M, Golicki D, Szumowski L, Wood KA, Szwed H. Translation and cultural adaptation of a Patient Perception of Arrhythmia Questionnaire in Poland. Kardiol Pol. 2014;72(3):246–53. doi: 10.5603/KP.a2013.0318.
    1. Golicki D, Jakubczyk M, Niewada M, Wrona W, Busschbach JJ. Valuation of EQ-5D health states in Poland: first TTO-based social value set in Central and Eastern Europe. Value Health. 2010;13(2):289–97. doi: 10.1111/j.1524-4733.2009.00596.x.
    1. Wood KA, Stewart AL, Drew BJ, Scheinman MM, Frolicher ES. Development and initial psychometric evaluation of the Patient Perspective of Arrhythmia Questionnaire. Res Nurs Health. 2009;32(5):504–16. doi: 10.1002/nur.20347.
    1. Haghjoo M, Arya A, Heidari A, Fazelifar AF, Sadr-Ameli MA. Electrophysiologic characteristics and results of radiofrequency catheter ablation in elderly patients with atrioventricular nodal reentrant tachycardia. J Electrocardiol. 2007;40(2):208–13. doi: 10.1016/j.jelectrocard.2006.05.002.
    1. Czech M, Opolski G, Zdrojewski T, Dubiel JS, Wizner B, Bolisega D, et al. The costs of heart failure in Poland from the public payer’s perspective. Polish programme assessing diagnostic procedures, treatment and costs in patients with heart failure in randomly selected outpatient clinics and hospitals at different levels of care: POLKARD. Kardiol Pol. 2013;71(3):224–32. doi: 10.5603/KP.2013.0032.
    1. Jaworski R, Jankowska EA, Ponikowski P, Banasiak W. Costs of management of patients with coronary artery disease in Poland: the multicenter RECENT study. Pol Arch Med Wewn. 2012;122(12):599–607.
    1. Ringborg A, Nieuwlaat R, Lindgren P, Jonsson B, Fidan D, Maggioni AP, et al. Costs of atrial fibrillation in five European countries: results from the Euro Heart Survey on atrial fibrillation. Europace. 2008;10(4):403–11. doi: 10.1093/europace/eun048.

Source: PubMed

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