Research Article An Economic Analysis of the Systematic Use of Mapping Systems during Catheter Ablation Procedures: Single Center Experience Massimiliano Marini , 1 Daniele Ravanelli, 2 Marta Martin, 1 Maurizio Del Greco, 3 Fabrizio Guarracini, 1 Silvia Quintarelli, 1 Alessio Coser, 1 Aldo Valentini, 2 and Roberto Bonmassari 1 1 Department of Cardiology, S. Chiara Hospital, Trento, Italy 2 Department of Physics, S. Chiara Hospital, Trento, Italy 3 Department of Cardiology, S. Maria del Carmine Hospital, Rovereto (TN), Italy Correspondence should be addressed to Massimiliano Marini; massimiliano.marini@apss.tn.it Received 28 June 2019; Accepted 28 July 2019; Published 20 August 2019 Academic Editor: Natale Daniele Brunetti Copyright © 2019 Massimiliano Marini et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. In this study we estimated the cost-efectiveness of adopting 3D Nonfuoroscopic Mapping Systems (NMSs) for catheter ablation (CA). Methods. Tis study includes patients who underwent supraventricular tachycardia (SVT) CA and atrial fbrillation (AF) CA from 2007 to 2016. A comparison was conducted between a reference year (2007) and the respective years for the two types of procedure in which the maximum optimization of patients’ exposure using NMSs was obtained. We compared the data of all SVT CA performed solely using fuoroscopy in 2007 (Group I) and all SVT CA procedures performed using fuoroscopy together with an NMS in 2011 (Group II). Tere was also an important comparison made between AF CA procedures performed in 2007 (Group III) and AF CA in 2012 (Group IV), where patients’ treatment in both years included the use of an NMS but where the sofware and hardware versions of the NMS were diferent. Two cost-efectiveness analyses were carried out. Te frst method was based on the alpha value (AV): the AV is a monetary reference value of avoided unit of exposure and is expressed as $/mansievert. Te second one was based on the value of a statistical life (VSL): the VSL does not represent the cost value of a person’s life, but the amount that a community would be willing to pay to reduce the risk of a person’s death. Te costs estimated from these two methods were compared to the real additional cost of using an NMS during that type of procedure in our EP Lab. Results. Te use of NMS reduced the efective dose of about 2.3 mSv for SVT and 23.8 mSv for AF CA procedures. Te use of NMS, applying directly AV or VSL values, was not cost-efective for SVT CA for the most countries, whereas the use of an NMS during an AF CA seemed to be cost-efective for most of them. Conclusions. In our analysis the cost-efectiveness of the systematic use of NMSs strongly depended on the AV and VSL values considered. Nonetheless, the approach seemed to be cost-efective only during AF CA procedures. 1. Introduction At the present time, the frst-line of therapy for many cardiac arrhythmias is considered to be radiofrequency catheter ablation (CA) [1, 2]. Te procedure is regarded by many electrophysiologists as a safe and an efective procedure with a high acute success rate; however, it may require an extensive use of X-ray for catheter placement [3, 4]. Te increased risk of developing cancer as a result of prolonged X-ray exposure time is well documented [5]. In the last ffeen years 3D nonfuoroscopic mapping systems (NMSs) have become established as an important tool for CA of complex arrhythmias. Studies published in research literature have, in addition, demonstrated that NMSs permit a signifcant reduction in X-ray exposure during standard CA procedures [6–10]. Nevertheless, daily use of NMSs during standard CA procedures is not a common practice in many EP Labs and the cost-efectiveness of using them remains an unknown. Even with the reality of common practice in this area, the International Commission on Radiation Protection (ICRP) advises the adoption of the As Low As Reasonably Achievable (ALARA) concept in relation to the basic approach to the use of fuoroscopy in medicine [11]. Hindawi BioMed Research International Volume 2019, Article ID 2427015, 10 pages https://doi.org/10.1155/2019/2427015