Assessment of Variation in Ambulatory Cardiac Monitoring Among Commercially Insured Patients.
Authors: Pierantonio Russo, MD; Henriette Coetzer, MD; Erik M. Hendrickson, PhD; Kenneth Boyle, DC; and Brent Wright, DrPH.
Summary:
Real World Evidence study on large commercial claims database focused on patients receiving their first ACM that showed clinical and economic outcomes can vary by ACM type and manufacturer.
Key Findings:
- Real world evidence study on 428,707 commercially insured adults (median age 49) between 2016 and 2023 with no prior arrhythmia diagnosis or ACM.
- Usage breakdown: LTCM 36%, Holter 36%, Event 27% (no MCT due to low volume in this private payer cohort).
- Zio LTCM (Zio XT and Zio monitor) was associated with higher diagnostic yield at 90 days, a lower likelihood of retesting at 180 days (except vs event), lower CV events, and lower HCRU and costs compared with other ACM types and other LTCM manufacturers.
- Diagnostic yield adjusted odds ratios at 90 days with Zio XT being reference: non-Zio LTCM – 0.64, Holter – 0.49, Event – 0.59.
- Retest rates adjusted odds ratios at 180 days with Zio XT being reference : non-Zio LTCM- 1.95, Holter – 2.16, Event – 0.94.
- Likelihood of CV related events at 1 year with Zio XT as reference: non-Zio LTCM – 1.23, Holter – 1.13, Event – 1.21.
- Healthcare Costs (All-cause medical + pharmacy costs) 1 year following monitoring with Zio XT as reference: non-Zio LTCM – 1.08, Holter – 1.05, Event – 1.1.
