Slotwiner David, Yu Jiani, Zhang Manyao, Al-Khatib Sana M
Department of Population Health Sciences, Weill Cornell Medical College, New York, New York.
Department of Population Health Sciences, Weill Cornell Medical College, New York, New York.
Heart Rhythm. 2025 Aug;22(8):2065-2072. doi: 10.1016/j.hrthm.2024.10.014. Epub 2024 Oct 11.
A 2015 expert consensus statement recommended that patients with cardiac implantable electronic devices receive remote monitoring and at least 1 in-office evaluation annually.
The purpose of this study was to examine whether patients who underwent implantation of a new cardiac implantable electronic device received care concordant with consensus statement recommendations.
We examined the rate of follow-up office visits and remote monitoring for 211,346 Medicare beneficiaries with an implantation of a new cardiac implantable electronic device between October 2015 and December 2020. We also assessed the characteristics of patients receiving follow-up care.
Within 16 weeks of implantation 77.8% of patients were seen in-office for a postoperative evaluation. The percentage of patients seen in office was 85.9% in the first 12 months, with 64.2% of patients seen in office every 2 years postimplantation, respectively. Following implantation, the percentage of beneficiaries receiving remote monitoring in the first 91 days was 14.7%, with 4.4% patients receiving remote monitoring every 91 days postimplantation within the first year. Patients who were ≥85 years old, nonwhite, or of lower income were less likely to receive office visits postimplantation.
Although most Medicare beneficiaries were seen in-office in the year following a new implant, the percentage of beneficiaries with an in-office visit declined in subsequent years. Fewer than 5% of beneficiaries had remote monitoring at the frequency recommended by the expert consensus statement. Patient demographics, including older age, nonwhite race, and lower income were associated with a lower likelihood of receiving care concordant with consensus statement recommendations.
2015年的一份专家共识声明建议，植入心脏植入式电子设备的患者应接受远程监测，并且每年至少进行1次门诊评估。
本研究旨在调查植入新型心脏植入式电子设备的患者所接受的治疗是否符合共识声明的建议。
我们调查了2015年10月至2020年12月期间植入新型心脏植入式电子设备的211,346名医疗保险受益人的门诊随访率和远程监测情况。我们还评估了接受后续治疗的患者的特征。
在植入后的16周内，77.8%的患者接受了术后门诊评估。在最初的12个月内，门诊就诊患者的比例为85.9%，植入后每2年分别有64.2%的患者接受门诊评估。植入后，前91天接受远程监测的受益人比例为14.7%，在第一年中，植入后每91天有4.4%的患者接受远程监测。年龄≥85岁、非白人或低收入患者植入后接受门诊就诊的可能性较小。
尽管大多数医疗保险受益人在植入新设备后的一年内接受了门诊治疗，但在随后几年中，门诊就诊受益人的比例有所下降。按照专家共识声明建议的频率进行远程监测的受益人不到5%。患者人口统计学特征，包括年龄较大、非白人种族和低收入，与接受符合共识声明建议的治疗的可能性较低有关。
