Learn More. This research is meant to establish if a patient monitored with mobile cardiac telemetry MCT sees different outcomes regarding diagnostic yield of arrhythmia, therapeutic management through the use of antiarrhythmic drugs, and cardiovascular costs incurred in the hospital setting when compared with more traditional monitoring devices, such as the Holter or the Event monitor.
Those claims came from the Truven database, an employer database that counts 2. Third, there are very significant inpatient cardiovascular savings in the tens of thousands of dollars for patients that undergo ablation, coronary artery bypass graft CABG and valve septa.
Given the superior outcome of MCT regarding both patient care and hospital savings, hospitals only stand to gain by enforcing protocols that favor the MCT system over the Event or the Holter monitor. The mobile cardiac telemetry MCT system is a small sensor and monitor that patients wear as they go about their daily lives.
This is not what happened though. Instead, patients continued to use the Holter and Event monitors. Both are small portable devices that the patient wears. Understandably, several payers responded by asking for hard evidence that indicates that the use of MCT indeed leads to better outcomes before they are to adopt MCT.
Several studies were undertaken to explain from a clinical standpoint how MCT leads to better outcomes. Unfortunately, those studies ran into challenges, and could not convincingly demonstrate causality. Is MCT not widely adopted just because studies fail to prove its effectiveness? Instead of focusing on explaining causality, this study set out to establish if patients that use MCT indeed have better outcomes.
The rationale that links the two was deliberately regarded as out of scope, otherwise this study would be fraught with the same issues that overwhelmed the previous ones. We conducted three analyses to assess the impact of usage of MCT on 1 diagnostic yield of arrhythmia, 2 management of arrhythmia through the use of antiarrhythmic drugs, and 3 cardiovascular costs incurred in the inpatient setting.
We then used for each of the three populations: 1 number of patients in the population none had an arrhythmia diagnosis prior to the use of the cardiac-monitoring device , and 2 number of patients within the previous group that had an arrhythmic ICD-9 diagnosis code after use of the cardiac-monitoring device.
We then computed the diagnostic yield as the ratio of 2 to 1. This analysis is similar to the previous one. The patient had to meet the following conditions:. We then used for each of the three populations: 1 number of patients in the population none had an arrhythmia diagnosis or took an antiarrhythmic drug prior to the cardiac-monitoring device , and 2 number of patients within the previous group that took an antiarrhythmic drug after the use of the cardiac-monitoring device.
We then computed the antiarrhythmic drug usage as the ratio of 2 to 1. The control patients had to meet the following conditions there were two groups: one for the Holter and the other for the Event monitor :. For pairing to happen, both the test and control patients had to meet the following conditions:. We then conducted the following measurements.
First, we compared MCT patients with paired-up Holter patients, and second with paired-up Event monitor patients. In both cases, we defined the following: 1 increase in cardiovascular expenses of MCT patients as the difference in cardiovascular costs incurred in the 12 months that followed MCT post-period and the cardiovascular costs incurred in the 12 months before MCT pre-period , 2 the corresponding per-patient difference of the matched control patients to the test patient, 3 the savings due to MCT compared with the other cardiac monitor as the difference between 1 and 2.
We chose a pair-wise test—control approach to allow for the fact that MCT patients may not be a homogeneous group and large differences between patients may occur. Also, we paired each test not with one but with five controls to minimize the vagaries of pairing.
MCT does not lead to any savings, what is happening is simply that costs are still incurred but delayed until the second year following MCT, which the test—control approach fails to pick up on as its postperiod ends before the significant costs are incurred. In the first case, we reran the analysis by imposing the condition that both test and control patients be from the same geography.
The results barely changed, knocking out the CPI argument. In the second case, we reran the analysis, extending the postperiod to 24 months. Once again, the results barely changed, undercutting the basis for the delay argument. Telemetry device storage varies. It can be stored locally or transmit the information to the cloud, as long as there is a strong cell signal present. This feature is significant because the data can be read in real time and irregularities can be addressed immediately.
This difference is especially prominent when compared to the day Holter monitors. Any irregularity identified with a Holter monitor will not be read until the monitor is returned and analyzed at the end of the prescribed wear time, which could potentially be up to 20 days later.
Both Holter monitors and telemetry devices require leads that are attached to the patient. Holter monitors typically require more leads and tend to be more bulky. As a result of the technology it uses, a telemetry device is smaller, sleeker and easier to wear. There are also differences in the ways the devices are powered. Based on the amount of wear time, Holter monitors may have batteries that need to be changed.
Newer telemetry device models are rechargeable. They typically include two batteries, one to wear while the other is charging. Your doctor will use a few tests to diagnose AFib and rule out anxiety. A heart monitor can detect less frequent irregular heartbeats.
Your doctor may suggest you wear one for a few days to try to capture AFib episodes. Can I wear a bra with a heart Holter monitor? Women should wear a comfortable bra and a shirt or blouse with buttons to allow ease in wearing the device.
Applying the Holter Monitor is a non-invasive procedure. You will be able to hide the wires under your clothing and the device will be attached to a belt or strap that you will wear during the 24 hour period. How do you sleep with a heart monitor? Do not swim, take a bath, or shower while wearing the monitor. Try to sleep on your back, with the recorder at your side. This will keep the patches from being pulled off. Avoid electric blankets, magnets, metal detectors, and high voltage areas such as power lines.
Can you exercise while wearing a heart monitor? Although your doctor might allow you to exercise while wearing a heart monitor, you should be aware that frequent movement and perspiration might loosen the adhesives and pull away the patches and hence compromise the quality of the recorded ECG trace, making it hard or impossible to perform diagnosis of the test. Why are patients put on telemetry? Telemetry monitoring is when healthcare providers monitor the electrical activity of your heart for an extended time.
Electrical signals control your heartbeat. The recordings taken during telemetry monitoring show healthcare providers if there are problems with how your heart beats. How long do you wear a heart monitor?
Twenty-four hour Holter monitoring is a continuous test to record your heart's rate and rhythm for 24 hours.
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