Is the systematic use of mapping systems during His Bundle catheter ablation cost‐effective? A single‐center experience

Introduction. In this study we estimated the cost-effectiveness of adopting 3D Nonfluoroscopic Mapping Systems (NMSs) for catheter ablation (CA). Methods. This study includes patients who underwent supraventricular tachycardia (SVT) CA and atrial fibrillation (AF) CA from 2007 to 2016. A comparison was conducted between a reference year (2007) and the respective years for the two types of procedure in which the maximum optimization of patients’ exposure using NMSs was obtained. We compared the data of all SVT CA performed solely using fluoroscopy in 2007 (Group I) and all SVT CA procedures performed using fluoroscopy together with an NMS in 2011 (Group II). There was also an important comparison made between AF CA procedures performed in 2007 (Group III) and AF CA in 2012 (Group IV), where patients’ treatment in both years included the use of an NMS but where the software and hardware versions of the NMS were different. Two cost-effectiveness analyses were carried out. The first method was based on the alpha value (AV): the AV is a monetary reference value of avoided unit of exposure and is expressed as $/mansievert. The second one was based on the value of a statistical life (VSL): the VSL does not represent the cost value of a person’s life, but the amount that a community would be willing to pay to reduce the risk of a person’s death. The costs estimated from these two methods were compared to the real additional cost of using an NMS during that type of procedure in our EP Lab. Results. The use of NMS reduced the effective dose of about 2.3 mSv for SVT and 23.8 mSv for AF CA procedures. The use of NMS, applying directly AV or VSL values, was not cost-effective for SVT CA for the most countries, whereas the use of an NMS during an AF CA seemed to be cost-effective for most of them. Conclusions. In our analysis the cost-effectiveness of the systematic use of NMSs strongly depended on the AV and VSL values considered. Nonetheless, the approach seemed to be cost-effective only during AF CA procedures.

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OP-103 ELECTROANATOMICAL MAPPING SYSTEMS WITH CARTO 3D IN CATHETER ABLATION OF CARDIAC ARRHYTHMIAS: A SINGLE CENTER EXPERIENCE

International Journal of Cardiology ◽

10.1016/s0167-5273(12)70051-7 ◽

2012 ◽

Vol 155 ◽

pp. S18-S19

Author(s):

A. Oto ◽

K. Aytemir ◽

U.N. Karakulak ◽

S. Okutucu ◽

B. Evranos ◽

...

Keyword(s):

Catheter Ablation ◽

Cardiac Arrhythmias ◽

Electroanatomical Mapping ◽

Single Center ◽

Single Center Experience ◽

Mapping Systems

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Fast-Track Extubation in Infants <7 kg Undergoing Congenital Heart Surgery is a Safe, Feasible, and Cost-Effective Concept: A 5-Year Single-Center Experience

10.1055/s-0040-1705560 ◽

2020 ◽

Author(s):

P. Murin ◽

V. Weixler ◽

O. Romanchenko ◽

A. Schulz ◽

F. Dehmel ◽

...

Keyword(s):

Congenital Heart ◽

Fast Track ◽

Heart Surgery ◽

Cost Effective ◽

Congenital Heart Surgery ◽

Single Center ◽

Single Center Experience

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Robotic hepatectomy is a safe and cost-effective alternative to conventional open hepatectomy: A single center experience

HPB ◽

10.1016/j.hpb.2020.04.753 ◽

2020 ◽

Vol 22 ◽

pp. S186-S187

Author(s):

J. Hawksworth ◽

N.P. Llore ◽

M.L. Holzner ◽

P. Radkani ◽

E. Mesler ◽

...

Keyword(s):

Cost Effective ◽

Effective Alternative ◽

Single Center ◽

Robotic Hepatectomy ◽

Single Center Experience ◽

Open Hepatectomy ◽

Cost Effective Alternative

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GW29-e1468 Pacing Parameters and Success Rate of Permanent His Bundle Pacing in Patients with Narrow QRS: From A Single Center Experience

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2018.08.654 ◽

2018 ◽

Vol 72 (16) ◽

pp. C140

Author(s):

Lan su ◽

Shengjie Wu ◽

Songjie Wang ◽

Zhengxian Wang ◽

Fangyi Xiao ◽

...

Keyword(s):

Success Rate ◽

Single Center ◽

His Bundle ◽

His Bundle Pacing ◽

Single Center Experience ◽

Narrow Qrs

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AMBULATORY LAPAROSCOPIC CHOLECYSTECTOMY IS SAFE AND COST-EFFECTIVE: a Brazilian single center experience

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032016000200010 ◽

2016 ◽

Vol 53 (2) ◽

pp. 103-107 ◽

Cited By ~ 13

Author(s):

Uirá Fernandes TEIXEIRA ◽

Marcos Bertozzi GOLDONI ◽

Mayara Christ MACHRY ◽

Pedro Ney CECCON ◽

Paulo Roberto Ott FONTES ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Selection Criteria ◽

Outpatient Surgery ◽

Gallstone Disease ◽

Cost Savings ◽

Cost Effective ◽

Single Center ◽

Single Center Experience ◽

Elective Laparoscopic Cholecystectomy ◽

Liver Biopsies

ABSTRACT Background - Laparoscopic cholecystectomy is the treatment of choice for gallstone disease, and has been perfomed as an outpatient surgery in many Institutions over the last few years. Objective - This is a retrospective study of a single center in Brazil, that aims to analyze the outcomes of 200 cases of ambulatory laparoscopic cholecystectomy performed by the same Hepato-Pancreato-Biliary team, evaluating the safety and cost-effectiveness of the method. Methods - Two hundred consecutive patients who underwent elective laparoscopic cholecystectomy were retrospectively analyzed; some of them underwent additional procedures, as liver biopsies and abdominal hernias repair. Results - From a total of 200 cases, the outpatient surgery protocol could not be carried out in 22 (11%). Twenty one (95.5%) patients remained hospitalized for 1 day and 1 (4.5%) patient remained hospitalized for 2 days. From the 178 patients who underwent ambulatory laparoscopic cholecystectomy, 3 (1.7 %) patients returned to the emergency room before the review appointment. Hospital cost was on average 35% lower for the ambulatory group. Conclusion - With appropriate selection criteria, ambulatory laparoscopic cholecystectomy is feasible, safe and effective; readmission rate is low, as well as complications related to the method. Cost savings and patient satisfaction support its adoption. Other studies are necessary to recommend this procedure as standard practice in Brazil.

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