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Pricey Heart Procedure Best for Younger Patients

'Left atrial catheter ablation' is new, effective and very expensive, study finds

TUESDAY, June 20, 2006 (HealthDay News) -- A treatment known as "left atrial catheter ablation" (LACA) that regulates irregular heartbeats may be a great benefit to some patients -- but at a high price, new research shows.

LACA is an effective treatment for atrial fibrillation, according to researchers at the University of Michigan Cardiovascular Center and the VA Ann Arbor Healthcare System. The procedure sends radiofrequency energy to stabilize the heartbeat, stopping the electrical circuits that cause the heart to beat irregularly.

The team calculated LACA's effectiveness using an advanced computer model. They concluded that the treatment was most successful and cost effective in patients around 55 years old who are at a high risk for stroke.

"Before LACA is more generally adopted as a treatment option, it's important to ask from a societal perspective if it's cost effective, and under what conditions," study author Dr. Paul Chan, a fellow in cardiovascular medicine at the U-M Medical School and member of the VA Health Services Research & Development Center, said in a prepared statement.

The computer model calculated outcomes by accounting for anticipated life expectancy, cost of the procedure and potential complications, lifetime cost of drugs to treat the condition, drugs patients should be taking, potential care-giving costs, and estimated stroke risk.

Reporting in the Journal of the American College of Cardiology, Chan's team estimated that LACA would cost an extra $98,000 per quality-adjusted life year in patients with atrial fibrillation who were not at increased risk of stroke. The standard threshold for an intervention to be considered cost-effective is $50,000 per quality-adjusted life year.

The researchers estimated the cost would total $28,700 per quality-adjusted life year in 55-year-old patients with additional risk factors for stroke beyond atrial fibrillation, meaning it was a cost-effective intervention in this group.

However, in the same group of patients aged 65 years old, the cost totaled $51,800.

According to Chan, "LACA doesn't have to have as big an impact on stroke risk to be cost effective for younger patients, because the benefits appreciate over their lifetime."

More information

For more on atrial fibrillation, head to the American Heart Association.

SOURCES: University of Michigan Health System, news release, June 19, 2006
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