Diagnostic yield and optimal duration of continuous-loop event monitoring for the diagnosis of palpitations : A cost-effectiveness analysis.
Continuous-loop event recorders are widely used for the evaluation of palpitations, but the optimal duration of monitoring is unknown.
To determine the yield, timing, and incremental cost-effectiveness of each week of event monitoring for palpitations.
Prospective cohort study.
105 consecutive outpatients referred for the placement of a continuous-loop event recorder for the evaluation of palpitations.
Diagnostic yield, incremental cost, and cost-effectiveness for each week of monitoring.
The diagnostic yield of continuous-loop event recorders was 1.04 diagnoses per patient in week 1,0.15 diagnoses per patient in week 2, and 0.01 diagnoses per patient in week 3 and beyond.
Over time, the cost-effectiveness ratio increased from $98 per new diagnosis in week 1 to $576 per new diagnosis in week 2 and $5832 per new diagnosis in week 3. Conclusions : In patients referred for evaluation of palpitations, the diagnostic yield of continuous-loop event recording decreases rapidly after 2 weeks of monitoring.
A 2-week monitoring period is reasonably cost-effective for most patients and should be the standard period for continuous-loop event recording for the evaluation of palpitations.
Mots-clés Pascal : Trouble rythme cardiaque, Electrocardiographie, Monitorage, Ambulatoire, Analyse coût efficacité, Economie santé, Etude longitudinale, Diagnostic, Homme, Appareil circulatoire pathologie, Cardiopathie, Electrodiagnostic
Mots-clés Pascal anglais : Arrhythmia, Electrocardiography, Monitoring, Ambulatory, Cost efficiency analysis, Health economy, Follow up study, Diagnosis, Human, Cardiovascular disease, Heart disease, Electrodiagnosis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0287265
Code Inist : 002B12A02. Création : 27/11/1998.