Presentation (CTI)

OBJECTIVES: Catheter ablation for ventricular tachycardia (VT) is a lengthy and technically demanding procedure. Recent advances in AI now allow reconstruction of a patient-specific 3D “digital twin” of the heart from CT-imaging, enabling pre-procedure identification of ablation targets. Clinical results of this inHEART application have been encouraging, such as reduced procedure times and fewer arrhythmic events, but cost-effectiveness studies of image-guided ablation have yet to be conducted.
METHODS: As part of the 1-year, randomized, controlled, multinational inEurHeart trial, we performed a cost-effectiveness analysis in France comparing CT-guided ablation using inHEART to conventional ablation in VT patients. Intervention costs were derived from detailed mapping of patients’ procedural pathway. Post-ablation resource use, including healthcare utilization, productivity losses, and informal care, was captured with IMTAs Medical Consumption Questionnaire, Productivity Cost Questionnaire and Informal Care Questionnaire, at 1, 3, 6, 9, and 12 months. QALYs were calculated using utility values of the EQ-5D-5L, administered at 1, 6, and 12 months. Costs are reported in 2025 Euros. Uncertainty around the estimates was assessed using bootstrapping.
RESULTS: Image-guided ablation yielded net cost savings in intervention costs of €796 (95% CI: - 1,542 to 3,732) driven by shorter procedure times, reduced use of high-density catheters, and shorter hospital stays. These fully offset the inHeart system cost. Over 12 months, cost savings were €3,590 (95% CI: - 1,789 to 9,352) from the healthcare perspective and €5,171 (95% CI: - 1,097 to 11,945) from the societal perspective. Both groups showed an equal development of quality of life, with no difference in QALYs. Probabilistic sensitivity analysis showed that the likelihood of cost savings was 88% from the healthcare perspective and 94% from the societal perspective.
CONCLUSIONS: CT-guided VT ablation with inHeart is likely to improve procedural efficiency and to generate cost savings while maintaining at least equivalent effectiveness to conventional ablation.