Cost-effectiveness of radiofrequency ablation compared with other strategies in Wolff-Parkinson-White syndrome.

Background: Patients with Wolff-Parkinson-White syndrome fall into four risk groups: those with (1) prior cardiac arrest, (2) paroxysmal supraventricular tachycardia or atrial fibrillation (PSVT/AF) with hemodynamic compromise, (3) PSVT/AF without hemodynamic compromise, and (4) no symptoms.

Methods And Results: For each group, we developed a cost-effectiveness analysis examining five clinical management strategies: (1) observation, (2) observation until a cardiac arrest dictates the need for therapy, (3) initial drug therapy guided by noninvasive monitoring, (4) initial radiofrequency ablation (RFA), and (5) initial surgical ablation. We used a Markov simulation model to estimate life expectancy and costs for patients whose ages are between 20 and 60 years.