Research & Publications

Summary

This retrospective cohort study of diagnostic-naïve patients who received first-time ambulatory cardiac monitoring (ACM) in 2017 to 2018 assesses the variation in monitoring strategy, clinical outcomes, and healthcare utilization in patients undergoing ambulatory monitoring without a pre-existing arrhythmia diagnosis.

The study evaluated arrhythmia encounter diagnosis at 3 months, repeat ACM testing at 6 months, all-cause 90-day emergency department (ED) and inpatient utilization, and cost of different strategies – long-term continuous monitor (LTCM); non-continuous, event-based external ambulatory event monitor (AEM); and mobile cardiac telemetry (MCT). We secondarily performed a device-specific analysis by manufacturer, identified from unique claim modifier codes.

There was large variation in diagnostic monitoring strategy. A specific LTCM was associated with the highest adjusted odds of a new arrhythmia diagnosis and lowest adjusted odds of repeat ACM testing. LTCM as a category had the lowest incremental acute care utilization. Different monitoring strategies may produce different results with respect to diagnosis and care.