Syncope Recurrence and Downstream Diagnostic Testing after Insertable Cardiac Monitor Placement for Syncope.

dc.contributor.author

Frazier-Mills, Camille G

dc.contributor.author

Johnson, Lawrence C

dc.contributor.author

Xia, Ying

dc.contributor.author

Rosemas, Sarah C

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Franco, Noreli C

dc.contributor.author

Pokorney, Sean D

dc.date.accessioned

2024-04-04T21:56:04Z

dc.date.available

2024-04-04T21:56:04Z

dc.date.issued

2022-08

dc.description.abstract

Despite advances in syncope evaluation strategies and risk stratification, the high cost of syncope is largely driven by extensive and often repetitive testing. This analysis of a large deidentified US claims database compared the use of diagnostic tests, therapeutic procedures, and the recurrence rate of acute syncope events before and after placement of an insertable cardiac monitor (ICM) in syncope patients. The patients had a minimum of 1 year of continuous enrollment before and 2 years after ICM placement. Among 2140 patients identified, a statistically significant reduction in the use of 14 out of 18 tests was observed during follow-up compared with pre-ICM testing. During the 2-year follow-up, 28.3% of patients underwent cardiac therapeutic interventions after a median of 127 days. Significantly fewer patients experienced acute syncope events during the 1st and 2nd years of ICM follow-up compared with the 1-year pre-ICM period, and the frequency of events per patient also decreased. In conclusion, reductions in diagnostic testing and acute syncope events were observed after ICM placement in a large real-world cohort of unexplained syncope patients. Further studies are needed to prospectively assess the impact of ICM vs. short-term monitoring on patient outcomes and healthcare utilization.

dc.identifier

diagnostics12081977

dc.identifier.issn

2075-4418

dc.identifier.issn

2075-4418

dc.identifier.uri

https://hdl.handle.net/10161/30476

dc.language

eng

dc.publisher

MDPI AG

dc.relation.ispartof

Diagnostics (Basel, Switzerland)

dc.relation.isversionof

10.3390/diagnostics12081977

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

diagnostic tests

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implantable loop recorder

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insertable cardiac monitor

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real-world claims data

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recurrent syncope

dc.title

Syncope Recurrence and Downstream Diagnostic Testing after Insertable Cardiac Monitor Placement for Syncope.

dc.type

Journal article

duke.contributor.orcid

Pokorney, Sean D|0000-0002-4345-0816

pubs.begin-page

1977

pubs.issue

8

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Institutes and Centers

pubs.organisational-group

Medicine

pubs.organisational-group

Medicine, Cardiology

pubs.organisational-group

Duke Clinical Research Institute

pubs.publication-status

Published

pubs.volume

12

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