Cardiac Implantable Electronic Device Patient Follow-Up: Assessment of U.S. Practice.
Academic Article
Overview
abstract
BACKGROUND: A 2015 expert consensus statement recommended that patients with cardiac implantable electronic devices receive remote monitoring and at least 1 in-office evaluation annually. OBJECTIVE: We examined whether patients who underwent implantation of a new cardiac implantable electronic device received care concordant with consensus statement recommendations. METHODS: 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. RESULTS: Within 16 weeks of implantation 77.8% of patients were seen in-office for a post-operative 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 two years post-implantation, 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 post-implantation within the first year. Patients who were ≥ 85 years old, non-white, or of lower income were less likely to receive office visits post-implantation. CONCLUSIONS: While 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 five percent of beneficiaries had remote monitoring at the frequency recommended by the expert consensus statement. Patient demographics, including older age, non-white race, and lower income were associated with a lower likelihood of receiving care concordant with consensus statement recommendations.
