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PSS24 INSERTABLE CARDIAC MONITOR (ICM) HEALTHCARE PATHWAYS OF PATIENTS WITH CARDIAC ARRHYTHMIAS BASED ON GERMAN STATUTORY HEALTH INSURANCE CLAIMS DATA

      Objectives

      Atrial fibrillation (AF) is often paroxysmal, many times remains undiagnosed and is associated with a five-fold increase in stroke risk. Insertable cardiac monitors (ICMs) with dedicated cardiac arrhythmia detection algorithms have been introduced into clinical practice for the diagnosis and monitoring of cardiac arrhythmia including AF in various clinical applications. The aim of this study was to compare two similar but differently managed AF patient groups: Patients that received an ICM (intervention group) and patients that were diagnosed with AF but did not receive an ICM (control group).

      Methods

      The anonymized database of 4.844.101 people insured in a representative German nationwide statutory health insurance scheme was analyzed. Patients that received an ICM and/or an AF diagnosis in the years 2012 or 2013 were extracted, matched and analyzed using propensity score matching to ensure comparability between the two cohorts. Their three-year longitudinal claims data were analyzed for the consumption of health care resources.

      Results

      A total of 360 patients were identified in the dataset (113 patients with an ICM and 247 comparable patients without an ICM). The mean age of the patients was 65 years (ICM intervention) and 70 years (control) old, and 57% were male. Over three years, the intervention group showed decreased mortality (5% versus 13%), had fewer anticoagulation medication prescriptions issued (91% versus 95%), fewer antiarrhythmic medication prescriptions (38% versus 47%), fewer physician visits (53 versus 60 visits), fewer hospitalizations per year (2.5 versus 3) and a reduced length of stay in hospital (31 versus 33 days).

      Conclusions

      Based on insurance claims data, AF patients that receive ICMs exhibit decreased mortality, consume fewer anticoagulation and antiarrhythmic prescriptions, fewer physician visits, fewer hospitalizations and have a decreased length of stay during hospitalizations. The above findings support the more frequent utilization of ICMs in the diagnostic pathway in eligible patients.