Abstract 12912: Effect of Real-Time Ambulatory Electrocardiography on Time-to-Intervention

Abstract

Background: Mobile cardiac telemetry (MCT) and event monitors are ambulatory electrocardiography (AECG) monitors to aid in the detection/diagnosis of arrhythmias. They are unique in their real-time alerts to clinicians. This contrasts with Holter monitoring, which is continuous but where results are not available until after completion of the exam, uploading, and clinician over-read. There is limited data on relative benefit for time to electrophysiology procedure and interventions. Hypothesis: Does real-time monitoring of AECG reduce the time to cardiac implantable electronic device procedure, ablation procedure, or healthcare encounter when compared to AECG without real-time monitoring? Methods: This is a retrospective observational analysis of University of Utah Health patients who underwent AECG studies from 2010-2022. The study cohort was stratified by patients with an ambulatory ECG that provides real-time event notification (CEM and MCT; hereafter Non-holter) versus those that do not (Holter). The outcomes of interest were cardiac device implantation, ablation procedure, and ER/hospitalization within 12 months, analyzed based on time-to-event using log-rank tests. Results: We identified 50 patients in the Holter group and 137 for the Non-holter group. The groups had similar baseline characteristics in terms of age, gender, and co-morbidities. The mean number of days to device implant was 68.1 and 66.36, to ablation procedure was 77.68 and 67.77, and to ER/hospital visit was 61.12 and 55.38 in the Holter and Non-holter groups respectively (Figure). Conclusion: There was not a statistically significant difference between AECG monitoring in real-time (Non-holter) and those without (Holter), however, there was a trend toward decreased time to intervention in the Non-holter group for each of the three outcomes. Future, larger cohorts may provide adequate power to determine if real-time monitoring does reduce time to the studied interventions.