Cardiac electrophysiology: a cost-effective approach

Clinical cardiac electrophysiology is a relatively new discipline, heavily dependent upon new technology that is often expensive. In cardiac pacing, no effective alternative to permanent pacing usually exists for patients with Class I indications, so cost-reduction strategies involve appropriate selection and utilization of hardware and facilities. Cost-effective utilization of radiofrequency ablation and implantable cardioverter-defibrillators requires that these techniques be compared with alternative therapies, usually antiarrhythmic drugs. Both ablation and defibrillator implantation can be shown to be cost effective in selected populations, but a cost-conscious approach to procedures and patient selection can make them cost effective in a broad range of patients.