{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:12:23Z","timestamp":1779286343832,"version":"3.51.4"},"reference-count":24,"publisher":"Becaris Publishing Limited","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Comp. Eff. Res."],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>\n                    <jats:bold>Aim:<\/jats:bold>\n                    To evaluate the cost-utility of pulsed field ablation (PFA) compared with radiofrequency ablation (RFA) and cryoablation, respectively, in Chinese patients with paroxysmal atrial fibrillation.\n                    <jats:bold>Materials &amp;<\/jats:bold>\n                    \u00a0\n                    <jats:bold>methods:<\/jats:bold>\n                    Patients with paroxysmal atrial fibrillation at different levels of atrial arrhythmia burden (&lt;0.1%, 0.1\u20139.9%, \u226510%) may experience various atrial arrhythmia burden states after undergoing ablation. A decision tree model was developed to simulate this process from a healthcare perspective, where patients could undergo a repeat ablation or experience a nonfatal stroke. Transition probabilities, clinical outcome and quality of life data were obtained from published sources and confirmed by expert physicians. Cost data were estimated from a survey of clinicians at tertiary hospitals, based on actual clinical practices. The uncertainty of results was explored through one-way sensitivity analysis and probabilistic sensitivity analysis by Monte Carlo simulation. The secondary outcome, return on investment, was calculated from hospital administrator perspective, as net revenue divided by total cost of certain ablation type.\n                    <jats:bold>Results:<\/jats:bold>\n                    PFA demonstrated favorable cost\u2013effectiveness compared with both RFA and cryoablation under the three-times China\u2019s per capita GDP threshold. When compared with RFA, PFA yielded an incremental 0.016 quality-adjusted life years (QALYs)\u00a0(0.859 vs 0.842) with an incremental cost\u2013effectiveness ratio\u00a0of \u00a537,000 per QALY gained. This cost\u2013effectiveness was primarily driven by savings of \u00a51558 in weighted repeat ablation surgery costs and \u00a5506 in long-term medication costs for anti-arhythmic and anticoagulants. When compared with cryoablation, PFA resulted in an incremental 0.006 QALYs (0.859 vs 0.852) with an incremental cost\u2013effectiveness ratio of \u00a5231,167 per QALY gained, mainly attributed to savings of \u00a51300 in repeat ablation surgery costs and \u00a5133 in long-term medication costs. As a secondary outcome, PFA yielded a return on investment of 0.313.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    PFA was likely to be more cost effective than both radiofrequency ablation and cryoablation in China. The study suggests that PFA represents a high-value intervention that aligns superior clinical outcomes with favorable hospital financial sustainability, supporting its prioritized adoption in the management of atrial fibrillation in China.\n                  <\/jats:p>","DOI":"10.57264\/cer-2025-0153","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T09:08:03Z","timestamp":1777453683000},"source":"Crossref","is-referenced-by-count":0,"title":["Health economic analysis of pulsed field ablation compared to conventional thermal ablation for patients with paroxysmal atrial fibrillation in China"],"prefix":"10.57264","volume":"15","author":[{"given":"Jian","family":"Ye","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youqi","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital, Jinan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifei","family":"Jian","sequence":"additional","affiliation":[{"name":"Health Economics Institute, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Gao","sequence":"additional","affiliation":[{"name":"Health Economics Institute, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4581-9826","authenticated-orcid":false,"given":"Shuting","family":"Chen","sequence":"additional","affiliation":[{"name":"Health Economics Institute, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianwei","family":"Xuan","sequence":"additional","affiliation":[{"name":"Health Economics Institute, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hesheng","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University &amp; Shandong Provincial Qianfoshan Hospital, Jinan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"36897","reference":[{"issue":"2","key":"e_1_3_7_3_2","first-page":"220","article-title":"Epidemiology of atrial fibrillation in China: 20-year trends","volume":"52","author":"Gao MY","year":"2024","unstructured":"Gao MY, He L, Du X Epidemiology of atrial fibrillation in China: 20-year trends. Chin. J. Cardiol. 52(2), 220\u2013226 (2024).","journal-title":"Chin. J. Cardiol."},{"issue":"18","key":"e_1_3_7_4_2","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.1056\/NEJMoa2307291","article-title":"Pulsed field or conventional thermal ablation for paroxysmal atrial fibrillation","volume":"389","author":"Reddy VY","year":"2023","unstructured":"Reddy VY, Gerstenfeld EP, Natale A Pulsed field or conventional thermal ablation for paroxysmal atrial fibrillation. N. Engl. J. Med. 389(18), 1660\u20131671 (2023).","journal-title":"N. Engl. J. 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