RADIOFREQUENCY CATHETER ABLATION VERSUS MEDICAL THERAPY FOR INITIAL TREATMENT OF SUPRAVENTRICULAR TACHYCARDIA AND ITS IMPACT ON QUALITY-OF-LIFE AND HEALTH-CARE COSTS

We prospectively compared the impact on quality of life and cost effec tiveness between ablation and medication as an initial strategy for pa tients with paroxysmal supraventricular tachycardia (SVT). Seventy-nin e consecutive patients with newly documented paroxysmal SVT were treat ed with either ablation or medication. Health surveys (SF-36 and disea se-specific questions) were obtained at baseline and after 12 months o f follow vp. Cost of health care utilization for the 6 months before a nd after treatment were measured. Both medication and ablation improve d quality of life. However, ablation improved quality of life in more general health categories than medication. At follow up, ablation was associated with significantly improved quality of life in the bodily p ain (63 +/- 24 vs 81 +/- 20, p <0.005), general health (69 +/- 21 vs 7 9 +/- 21,p <0.05), vitality (55 +/- 21 vs 66 +/- 22, p <0.05), and rol e emotion (78 +/- 36 vs 94 +/- 17, p <0.05) categories when compared w ith medication. Although both medication and ablation decreased freque ncy of disease-specific symptoms, ablation resulted in complete amelio ration of symptoms in more patients (33% vs 74%). Potential long-term costs were similar for medication and ablation, In conclusion, ablatio n Improves health-related quality of life to a greater extent, and in more aspects of general and disease-specific health than medication. ( C) 1998 by Excerpta Medica, Inc.