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Insertable cardiac monitor procedure safe regardless of setting
Insertion of a miniaturized cardiac monitor was associated with positive safety outcomes whether in an office or hospital setting, according to new data published in Heart Rhythm.
“This is the first randomized study to directly compare the safety of [insertable cardiac monitor] insertion in an office vs. hospital environment,” John D. Rogers, MD, from the Scripps Green Hospital in La Jolla, California, and colleagues wrote in the study.
Rogers and colleagues analyzed 521 patients who were indicated for an insertable cardiac monitor (Reveal LINQ, Medtronic). The patients were randomly assigned to insertion in a hospital or office environment at 26 centers across the United States between March 30, 2015, and Jan. 19, 2016.
Patients were then assessed for adverse events at follow-up visits at 30 and 90 days.
Insertion of the device was successful in all 482 patients in which it was attempted (office, 251; hospital, 231). The untoward event rate, which was made up of the composite of unsuccessful insertion and device- or insertion-related complications, was 0.8% (2 of 244) in the office group and 0.9% (2 of 227) in the hospital group (95% CI, 3 to 2.9), Rogers and colleagues wrote.
There were adverse events in six of 244 (2.5%) patients in the office group and in 10 of 227 (4.4%) patients in the hospital group (95% CI [office minus in-hospital rates], 5.8 to 1.9), the researchers found.
Procedures performed in an office had fewer delays of more than 15 minutes (16% vs. 35%; P < .001), and patient response was more often “very positive” compared with hospital insertions, according to the researchers.
Additionally, the inserting physicians said the office location was “very convenient” 85% of the time vs. 27% of the time for the hospital location (P < .001), Rogers and colleagues wrote.
“Compared with the hospital setting, office-based procedures have been shown to provide increased patient satisfaction and physician and patient convenience across a number of disciplines,” Rogers and colleagues wrote. “In agreement with these previous observations, [insertable cardiac monitor] insertion in an office vs. hospital was associated with improved patient response and increased physician convenience and satisfaction in the present investigation.” – by Dave Quaile
Disclosure: The study was sponsored by Medtronic. Rogers reports receiving speaking fees, consultant fees and research grants from Medtronic and speaking fees and research grants from St. Jude Medical. Please see the full study for a list of the other researchers’ relevant financial disclosures.