Abstract 13938: Trends in In-Hospital Implantation of Implantable Cardiac Monitors in the Unites States: 2016-2019

Abstract

Introduction: Implantable cardiac monitors (ICM) are widely employed for long-term cardiac rhythm monitoring. While a majority of ICMs are implanted on an outpatient basis, national estimates on their use in the inpatient setting are lacking. Methods: The National Inpatient Sample and the National Readmission Database were queried to identify inpatient ICM implantations between 2016 and 2019. Baseline characteristics, in-hospital outcomes, readmission rates, and trends over time were assessed for the study population and compared between the largest diagnostic cohorts: neurologic and cardiac. Results: A total of 101,430 adults underwent in-hospital ICM implantation between 2016 and 2019 (52.9% neurologic, 39.2% cardiac). Patient characteristics and outcomes are shown in Table 1. There was a 170% increase in inpatient ICM procedures from 2016 to 2019. Significant changes in patient profiles and readmission rates were observed over the study period. The trends are shown in Table 2a. After adjusting for confounders, patients with cardiac indications were more likely to have complications and be readmitted, but had lower mortality, length of stay, and hospitalization cost compared with the neurology cohort. The ORs are shown in Table 2b. Conclusions: The number of inpatient ICM implantations has increased significantly, likely reflecting expanding indications. The profiles of patients receiving ICM also changed to include more primary neurologic indications, comorbidities, and non-white races. Small and medium sized hospitals performed the procedure more frequently. Complication rates were extremely low and remained constant during the study period.