POSA154 A Comparison of the Costs of Atrial Fibrillation Ablation Using Radiofrequency and Cryobaloon Technologies in the United Kingdom and Italy


      Currently, approximately 1 million people in the United Kingdom (UK) and Italy are affected by atrial fibrillation (AF). Catheter ablation effectively restores sinus rhythm in AF patients. Our objective was to simulate and compare annual AF ablation costs with radiofrequency (RF) and cryoballoon (CB) catheters from public healthcare provider perspectives in the UK and Italy.


      An economic analysis was conducted to simulate AF centers with annual procedure volumes of 50, 150, or 350 ablations. Cardiovascular (CV)-related hospital readmission rates during months 4-12 after AF ablation (4.47% and 6.70% for RF and CB, respectively) were informed by an analysis of the United States Premier Healthcare claims database (Pollack 2019), and were applied to the UK and Italy assuming consistency across countries. Index procedure costs for the UK (£7707 and £9911 for RF and CB, respectively) were from the National Institute for Health and Care Excellence AF Clinical Guideline (2021 £); these costs were not available for Italy. CV-related readmission costs were from the UK Hospital Episodes Statistics (2014-2019; inflated to 2021 £) and Italian National Hospital Information System (2008-2016; 2021 €) databases.


      For the UK, potential annual treatment costs were lower for RF than for CB ablation, with 97% of total cost savings attributable to index procedures. Annual index procedure savings with RF ranged from £110200 to £771400 and CV-related readmission savings with RF ranged from £2064 to £14447 for 50 or 350 ablations, respectively. For Italy, CV-related readmission savings for RF ranged from €3828 to €26798 compared with CB.


      Potential annual AF ablation treatment costs were lower with RF compared to CB in the UK and Italy. Both index procedures and readmissions contributed to potential cost savings in the UK analysis.