Pediatric Cardiology

, Volume 39, Issue 8, pp 1581–1589 | Cite as

A Cost-Effective Analysis of Systematically Using Mapping Systems During Catheter Ablation Procedures in Children and Teenagers

  • Massimiliano MariniEmail author
  • Daniele Ravanelli
  • Fabrizio Guarracini
  • Maurizio Del Greco
  • Silvia Quintarelli
  • Anna Cima
  • Alessio Coser
  • Marta Martin
  • Aldo Valentini
  • Roberto Bonmassari
Original Article


The aim of this study is to evaluate the cost-effectiveness of an extended use of 3D non-fluoroscopic mapping systems (NMSs) during paediatric catheter ablation (CA) in an adult EP Lab. This study includes 58 consecutive patients (aged between 8 and 18) who underwent CA from March 2005 to February 2015. We compare the fluoroscopy data of two groups: group I, patients who underwent CA from 2005 to 2008 using only fluoroscopy, and group II, patients who underwent CA from 2008 to 2015 performed also using NMSs. Two cost-effectiveness analyses were carried out: the first method was based on the alpha value (AV), and the second one was based on the value of a statistical life (VSL). For both methods, a children’s correction factor was also considered. The reduction cost estimated from all these methods was compared to the real additional cost of using NMSs. The use of an NMS during a CA procedure has led to an effective dose reduction (ΔE) of 2.8 milli-Sievert. All presented methods are based on parameters with a wide range of values. The use of an NMS, applying directly AV values or VSL values, is not cost-effective for most countries. Only considering the children’s correction factor, the CA procedure using an NMS seems to be cost-effective. The cost-effectiveness of a systematic use of NMSs during CA procedures in children and teenagers remains a challenging task. A positive result depends on which value of AV or VSL is considered and if the children’s correction factor is applied or not.


Electrophysiological procedures Paediatric population Non-fluoroscopic imaging Electro anatomic mapping system Cost-effectiveness 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research Involving Human and Animal Participants

This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Massimiliano Marini
    • 1
    Email author
  • Daniele Ravanelli
    • 2
  • Fabrizio Guarracini
    • 1
  • Maurizio Del Greco
    • 3
  • Silvia Quintarelli
    • 1
  • Anna Cima
    • 4
  • Alessio Coser
    • 1
  • Marta Martin
    • 5
  • Aldo Valentini
    • 2
  • Roberto Bonmassari
    • 1
  1. 1.Department of CardiologyS. Chiara HospitalTrentoItaly
  2. 2.Department of PhysicsS. Chiara HospitalTrentoItaly
  3. 3.Department of CardiologyS. Maria del Carmine HospitalRoveretoItaly
  4. 4.Department of CardiologyCazzavillan HospitalArzignanoItaly
  5. 5.Department of Cardiac, Thoracic, and Vascular SciencesUniversity of PadovaPaduaItaly

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