We prospectively compared the impact on quality of life and cost effectiveness between
ablation and medication as an initial strategy for patients with paroxysmal supraventricular
tachycardia (SVT). Seventy-nine consecutive patients with newly documented paroxysmal
SVT were treated with either ablation or medication. Health surveys (SF-36 and disease-specific
questions) were obtained at baseline and after 12 months of follow up. Cost of health
care utilization for the 6 months before and after treatment were measured. Both medication
and ablation improved quality of life. However, ablation improved quality of life
in more general health categories than medication. At follow up, ablation was associated
with significantly improved quality of life in the bodily pain (63+/-24 vs 81+/-20,
p <0.005), general health (69+/-21 vs 79+/-21, p <0.05), vitality (55+/-21 vs 66+/-22,
p <0.05), and role emotion (78+/-36 vs 94+/-17, p <0.05) categories when compared
with medication. Although both medication and ablation decreased frequency of disease-specific
symptoms, ablation resulted in complete amelioration of symptoms in more patients
(33% vs 74%). Potential long-term costs were similar for medication and ablation.
In conclusion, ablation improves health-related quality of life to a greater extent,
and in more aspects of general and disease-specific health than medication.