Total | Implantable loop recorder | Long-term continuous external monitor | Holter monitor | Global p value | |||||
N | % | N | % | N | % | N | % | ||
Cohort N | 48 901 | 100 | 9235 | 18.9 | 29 103 | 59.5 | 10 563 | 21.6 | |
Age, years (mean, SD) | 69.9 | 11.9 | 69.6 | 11.4 | 69.8 | 12.0 | 70.5 | 12.0 | <0.001 |
Gender | |||||||||
Female | 26 148 | 53.5 | 4688 | 50.8 | 15 729 | 54.1 | 5731 | 54.3 | <0.001 |
Male | 22 753 | 46.5 | 4547 | 49.2 | 13 374 | 46.0 | 4832 | 45.7 | <0.001 |
Insurance type | |||||||||
Commercial | 12 417 | 25.4 | 2477 | 26.8 | 7567 | 26.0 | 2373 | 22.5 | <0.001 |
Medicare Advantage | 36 469 | 74.6 | 6754 | 73.2 | 21 526 | 74.0 | 8189 | 77.5 | <0.001 |
Index device year | |||||||||
2016 | 5759 | 11.8 | 885 | 9.6 | 2934 | 10.1 | 1940 | 18.4 | <0.001 |
2017 | 7657 | 15.7 | 1311 | 14.2 | 4205 | 14.5 | 2141 | 20.3 | <0.001 |
2018 | 9200 | 18.8 | 1857 | 20.1 | 5245 | 18.0 | 2098 | 19.9 | <0.001 |
2019 | 11 081 | 22.7 | 2189 | 23.7 | 6834 | 23.5 | 2058 | 19.5 | <0.001 |
2020 | 10 610 | 21.7 | 1971 | 21.3 | 7158 | 24.6 | 1481 | 14.0 | <0.001 |
2021 | 4594 | 9.4 | 1022 | 11.1 | 2727 | 9.4 | 845 | 8.0 | <0.001 |
Monitoring device placement setting | |||||||||
Monitoring device placement date between a hospitalisation and discharge | 8451 | 17.3 | 3777 | 40.9 | 3748 | 12.9 | 926 | 8.8 | <0.001 |
Monitoring device placement same day as emergency department visit | 4762 | 9.7 | 2556 | 27.7 | 1670 | 5.7 | 536 | 5.1 | <0.001 |
Procedures of interest | |||||||||
Holter monitor utilisation during 6 months prior to index device placement | 2502 | 5.1 | 681 | 7.4 | 1821 | 6.3 | 0 | 0 | <0.001 |
External cardiac monitor utilisation during 6 months prior to index device | 2043 | 4.2 | >2031* | >21.0* | 0 | 0 | <11* | <0.1* | <0.001 |
CHA2DS2-VASc score and comorbidities (based on 6-month baseline period†) | |||||||||
Heart failure | 7772 | 15.9 | 1565 | 17.0 | 4467 | 15.4 | 1740 | 16.5 | <0.001 |
Hypertension | 42 146 | 86.2 | 8238 | 89.2 | 24 916 | 85.6 | 8992 | 85.1 | <0.001 |
Diabetes | 17 815 | 36.4 | 3531 | 38.2 | 10 434 | 35.9 | 3850 | 36.5 | <0.001 |
Coronary artery disease | 17 535 | 35.9 | 3649 | 39.5 | 10 054 | 34.6 | 3832 | 36.3 | <0.001 |
Peripheral arterial disease | 2317 | 4.7 | 405 | 4.4 | 1235 | 4.2 | 677 | 6.4 | <0.001 |
Thromboembolism | 46 182 | 94.4 | 9082 | 98.3 | 27 685 | 95.1 | 9415 | 89.1 | <0.001 |
CHA2DS2-VASc—continuous (mean, SD) | 5.3 | 1.5 | 5.4 | 1.5 | 5.3 | 1.5 | 5.3 | 1.6 | <0.001 |
CHA2DS2-VASc score of 2 or 3 | 6613 | 13.5 | 1041 | 11.3 | 3989 | 13.7 | 1583 | 15.0 | <0.001 |
CHA2DS2-VASc score of 4 or more | 42 288 | 86.5 | 8194 | 88.7 | 25 114 | 86.3 | 8980 | 85.0 | <0.001 |
Long-term care stays during baseline period | |||||||||
Cumulative long-term care days (could be non-consecutive), mean (SD) | 5.3 (11.2) | 7.1 (12.1) | 5.0 (10.4) | 4.4 (12.1) | <0.001 | ||||
≥45 long-term care days | 745 | 1.5 | 167 | 1.8 | 396 | 1.4 | 182 | 1.7 | 0.002 |
≥90 long-term care days | 97 | 0.20 | 24 | 0.26 | 43 | 0.15 | 30 | 0.28 | 0.009 |
*Masked to meet small cell suppression policy.
†Baseline period includes the inpatient-stay adjusted index date and 182 days prior to the index date.
CHA2DS2-VASc score, 1 point for congestive heart failure, 1 point for hypertension, 1 point for diabetes mellitus, 2 points for ischaemic stroke/transient ischaemic attack/thromboembolism, 1 point for vascular diseases, 1 point for age 65–74 years, 2 points for age ≥75 years and 1 point for female sex.