基于导管消融术治疗房颤的治疗型医疗器械经济性评估OA

Objective:To assess economic value of catheter ablation(CA)in treating atrial fibrillation(AF),and to analyze feasibility of assessing economic value of therapeutic medical devices.Methods:Relevant literatures that CA treated AF were retrieved from Chinese and international databases,including China National Knowledge Infrastructure(CNKI),Wanfang,PubMed(United State American),Cochrane Library(United Kingdom),Embase(Netherlands),and SinoMed(China).Both Chinese and English keywords were used.The literature search covered the period from January 2015 to January 2025.The referenceability of existing domestic and international economic evaluations of CA to current decision-making practice of China in treating AF was analyzed.Based on discrete event simulation(DES)model,the economic value of therapeutic medical devices of main CA technique in treating AF was assessed from the perspective of the Chinese healthcare system.Results:A total of 35 articales related to CA of treating AF were identified.After excluding non-economic evaluation studies,15 articles were finally included for economic evaluation of CA in treating AF.Compared with antiarrhythmic drugs(AADs),CA was a treatment option with cost-effectiveness for AF.In the current Chinese context,the mainstream ablation techniques include uses ThermoCool SmartTouch catheter to combine with the ablation index(STAI)technique to conduct radiofrequency catheter ablation(RFCA),and second-generation cryoballoon ablation(CB-2),and AADs.Conclusion:RFCA has greater economic efficiency in treating AF than AADs and CB-2.The assessment of economic value of therapeutic medical devices is characterized by"environmental specificity"and"shorter shelf life".It is nessesary to choose reliable research methods to re-carry out economic evaluations for current decision-making environment when the external environment fails to reflect the current payment systems,price levels,and clinical application patterns,so as to ensure the reliability and applicability of the assessed results.