{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T05:46:44Z","timestamp":1774676804874,"version":"3.50.1"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,8,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This study sought to assess payer costs following cryoballoon or radiofrequency current (\n              <jats:styled-content style=\"fixed-case\">RFC<\/jats:styled-content>\n              ) catheter ablation of paroxysmal atrial fibrillation in the randomized\n              <jats:styled-content style=\"fixed-case\">FIRE AND ICE<\/jats:styled-content>\n              trial.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A trial period analysis of healthcare costs evaluated the impact of ablation modality (cryoballoon versus\n              <jats:styled-content style=\"fixed-case\">RFC<\/jats:styled-content>\n              ) on differences in resource use and associated payer costs. Analyses were based on repeat interventions, rehospitalizations, and cardioversions during the trial, with unit costs based on 3 national healthcare systems (Germany [\u20ac], the United Kingdom [\u00a3], and the United States [\n              <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" overflow=\"scroll\">\n                <mml:mi mathvariant=\"normal\">$<\/mml:mi>\n              <\/mml:math>\n              ]). Total payer costs were calculated by applying standard unit costs to hospital stays, using\n              <jats:italic>International Classification of Diseases, 10th Revision<\/jats:italic>\n              diagnoses and procedure codes that were mapped to country\u2010specific diagnosis\u2010related groups. Patients (N=750) randomized 1:1 to cryoballoon (n=374) or\n              <jats:styled-content style=\"fixed-case\">RFC<\/jats:styled-content>\n              (n=376) ablation were followed for a mean of 1.5\u00a0years. Resource use was lower in the cryoballoon than the\n              <jats:styled-content style=\"fixed-case\">RFC<\/jats:styled-content>\n              group (205 hospitalizations and\/or interventions in 122 patients versus 268 events in 154 patients). The cost differences per patient in mean total payer costs during follow\u2010up were \u20ac640, \u00a3364, and\n              <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" overflow=\"scroll\">\n                <mml:mi mathvariant=\"normal\">$<\/mml:mi>\n              <\/mml:math>\n              925 in favor of cryoballoon ablation (\n              <jats:italic>P<\/jats:italic>\n              =0.012, 0.013, and 0.016, respectively). This resulted in trial period total cost savings of \u20ac245\u00a0000, \u00a3140\u00a0000, and\n              <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" overflow=\"scroll\">\n                <mml:mi mathvariant=\"normal\">$<\/mml:mi>\n              <\/mml:math>\n              355\u00a0000.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              When compared with\n              <jats:styled-content style=\"fixed-case\">RFC<\/jats:styled-content>\n              ablation, cryoballoon ablation was associated with a reduction in resource use and payer costs. In all 3 national healthcare systems analyzed, this reduction resulted in substantial trial period cost savings, primarily attributable to fewer repeat ablations and a reduction in cardiovascular rehospitalizations with cryoballoon ablation.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Identifier: NCT01490814.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.006043","type":"journal-article","created":{"date-parts":[[2017,7,28]],"date-time":"2017-07-28T00:40:25Z","timestamp":1501202425000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":41,"title":["The Impact of Cryoballoon Versus Radiofrequency Ablation for Paroxysmal Atrial Fibrillation on Healthcare Utilization and Costs: An Economic Analysis From the FIRE AND ICE Trial"],"prefix":"10.1161","volume":"6","author":[{"given":"K. R. Julian","family":"Chun","sequence":"first","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien, Frankfurt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep","family":"Brugada","sequence":"additional","affiliation":[{"name":"Hospital Clinic, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arif","family":"Elvan","sequence":"additional","affiliation":[{"name":"Isala Klinieken, Zwolle, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laszlo","family":"Gell\u00e9r","sequence":"additional","affiliation":[{"name":"Semmelweis University, Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Busch","sequence":"additional","affiliation":[{"name":"University Hospital, Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Barrera","sequence":"additional","affiliation":[{"name":"Institute of Cardiotechnology, Benalm\u00e1dena, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J.","family":"Schilling","sequence":"additional","affiliation":[{"name":"Cardiology Research Department, Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew R.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Lahey Hospital and Medical Center, Harvard Clinical Research Institute, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert B.","family":"Hokanson","sequence":"additional","affiliation":[{"name":"Medtronic Inc., Minneapolis, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reece","family":"Holbrook","sequence":"additional","affiliation":[{"name":"Medtronic Inc., Minneapolis, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedict","family":"Brown","sequence":"additional","affiliation":[{"name":"Medtronic International Trading Sarl, Tolochenaz, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Schl\u00fcter","sequence":"additional","affiliation":[{"name":"Asklepios Klinik St. Georg, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl\u2010Heinz","family":"Kuck","sequence":"additional","affiliation":[{"name":"Asklepios Klinik St. Georg, Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the FIRE AND ICE 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