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Healthcare systems face an increasing demand for costly medical interventions. The primary concern of a physician is centred around the best possible treatment for his or her patients, according to patients' requests and expectations. The healthcare system, in contrast, is ideally concerned with the assignment of resources in the best interest of society.1 Clinicians, public health physicians, economists, commissioners, managers, and politicians need to find ways to balance between what is best for the individual patient and what society can realistically afford.1–3 Appraisals of the clinical effectiveness, cost-effectiveness, cost-impact, and commissioning of emerging therapies can inform such judgements and decisions.Health technology assessments (HTAs) provide a means for assessing the clinical and cost-effectiveness of healthcare interventions.4 The aim of HTAs is to provide unbiased, rigorous, and transparent guidance in the application of emerging therapies, in the background of available resources.5,6 They are, in effect, a link between clinical evidence and policy-making, informing government agencies, healthcare professionals and administrators, private sector organizations, the healthcare industry, as well as patients, carers, and the general public.The past decade has witnessed relentless advances in interventional electrophysiology and device therapy. This has mainly been attributable to the development of cardiac resynchronization therapy (CRT),7 the widening indications for implantable cardioverter defibrillator therapy,8,9 and the emergence of ablation for atrial fibrillation (AF).10–12 Characteristically, these therapies involve initial costly equipment and procedures, delivered in a specific infrastructure, while their benefits are generally accrued over the long term. Not surprisingly, such therapies attract scrutiny from commissioners and policy-makers. In this position paper, we review a series of issues that are related to HTAs for catheter ablation and device therapy and that in our view deserve attention.The mission of a HTA is to …

Health technology assessment in interventional electrophysiology and device therapy: a position paper of the European Heart Rhythm Association