Cost effectiveness of LAA closure in patients with AF and contraindications to warfarin: comment

This study evaluated the costs of percutaneous left atrial appendage closure (LAAC) using the Watchman device (Boston Scientific, Marlborough, MA). As pointed out by the authors, procedures to implement percutaneous devices are associated with a 6.7% short-term risk of major complications (air embolism, major bleeding, and pericardial effusion). Moreover, the device and technical platform necessary for the procedure come at a significant cost (€9136). Despite these downsides, assuming a willingness-to-pay threshold of€30 000 per quality-adjusted life-year gained, the authors found that relative to both aspirin and apixaban, LAAC was cost effective at 8 years. Left atrial appendage closure was also likely cost effective in patients with contraindications to warfarin at 10 years.
Source: Europace - Category: Cardiology Source Type: research