Cost-effectiveness of catheter ablation in end-stage heart failure with atrial fibrillation: Insights from CASTLE-HTx.
Priyanka Boettger, Maximilian Moersdorf, Philipp Sommer et al.
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In 30 seconds
The CASTLE-HTx trial evaluated the cost-effectiveness of catheter ablation combined with guideline-directed medical therapy (GDMT) versus medical therapy alone in 194 patients with end-stage heart failure and atrial fibrillation. The study found that the combination therapy resulted in a mean survival gain of approximately 1.7 life-years per patient at an incremental cost of about €12,000, yielding an incremental cost-effectiveness ratio of approximately €7300 per life-year gained.
Key findings
- The combination of catheter ablation and GDMT resulted in a mean survival gain of ∼1.7 life-years per patient.
- The incremental cost-effectiveness ratio was approximately €7300 per life-year gained.
- At 36 months, the combination therapy provided a gain of 0.34 life-years.
- Both lifetime and 36-month incremental cost-effectiveness ratios were below €50,000 per QALY.
Why it matters
Understanding the cost-effectiveness of treatment options in end-stage heart failure with atrial fibrillation is crucial for healthcare decision-making, particularly in resource-limited settings. This study provides evidence that catheter ablation combined with GDMT is a financially viable option.