PCV17 HEALTHCARE UTILIZATION PRIOR TO AN INITIAL DIAGNOSIS OF PAROXYSMAL SUPRVENTRICULAR TACHYCARDIA IN A LARGE HEALTHCARE SYSTEM

Abstract

Paroxysmal supraventricular tachycardia (PSVT) is an acute, episodic cardiac rhythm disorder that can be challenging to diagnose because of its episodic nature. Patients may be diagnosed with other arrhythmias prior to initial PSVT diagnosis. This study assesses prior healthcare utilization for related cardiac arrhythmias in patients newly diagnosed with PSVT. Patients with a PSVT diagnosis (ICD-9 CM: 427.0) recorded in the EMR between January 1st and August 31, 2015 were identified within Atrium Health, a large healthcare system in the southeastern United States. Other cardiac arrhythmia diagnoses were identified between January 1, 2008 and December 31, 2014. These diagnoses were stratified into those with higher or lower probabilities of confirmed PSVT (ICD-9-CM: 426.7; 427.2; 427.9 and ICD-9-CM: 427.61; 427.89; 785.0; 785.1, respectively (Go et al., 2018)). Patient demographics and patient encounters were summarized overall and for the two subgroups. The study included 920 patients with a PSVT diagnosis (average age 59y SD 18; 63% female). Of these, 348 (37.8%) were diagnosed in the Emergency Department (ED). Across all patients, 77% (N=710) had an average 4.2 prior encounters with a PSVT-related diagnosis (average age 63y SD 19; 65% female); (61% in the ED). 75% of patients (N=691/920) had diagnoses associated with a low probability of being PSVT (average age 58y SD 19; 65% female) with an average 4.1 prior encounters; (63% in the ED). 20% of patients (N=181/920) had on average 1.7 prior encounters with a diagnosis associated with a higher probability of “true” PSVT (average age 57y SD 20; 58% female); (50% in the ED). This study provides real-world evidence that prior to a PSVT diagnosis, patients have multiple healthcare encounters for symptoms related to PSVT. Innovations in therapies to address symptoms related to PSVT could reduce future healthcare utilization for patients who will ultimately get a confirmed PSVT diagnosis.