Trends in health care resource use and expenditures in patients with newly diagnosed paroxysmal supraventricular tachycardia in the United States

Chew, Derek S.; Sacks, Naomi; Emden, Maia R.; Preib, Madison T; Cyr, Philip L.; Wood, D.; Pokorney, Sean D.

doi:10.1016/j.ahj.2020.12.012

Cited by 7 publications

(8 citation statements)

References 14 publications

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“…A review of the records was performed for all potential cases using an algorithm based on standard ECG criteria for SVT to interpret ECG and then identify the potentially eligible arrhythmia. The criteria were as follows: (1) paroxysmal occurrence (sinus and episodes of tachycardia), (2) narrow QRS complex configuration or pre-excited bundle branch block, (3) variation in successive RR ≤ 40 ms, (4) ventricular rate ≥ 120 bpm, (5) no evidence of AV dissociation and (6) no identifiable P-waves preceding the QRS complex during tachycardia [11]. The ECG identified as potentially eligible AVNRT or AVRT was then confirmed by the electrophysiologist.…”

Section: Validation Of Heart-rhythmmentioning

confidence: 99%

“…Episodes of rapid heart rate with tachycardia-related signs and symptoms are a reason why people seek medical attention at health care centres (HCCs) or emergency departments (EDs) [1][2][3]. The episodes may affect patients' daily lives, as well as their need for medical assistance, generating consequences for individuals (repeated investigations/visits, social disadvantages, and economic costs) [4][5][6] and society (costs to the national economy and the consumption of health care resources) [5,7,8]. The severity of the episodes and the presence of signs and symptoms is highly variable, depending on the patient's heart rate, duration of tachycardia, underlying heart disease, and individual experience [1,9].…”

Section: Introductionmentioning

confidence: 99%

“…Electrocardiograms (ECGs) with ongoing SVT show a characteristic tachycardia pattern, while this finding is valuable for the assessment, it can be challenging since the episode may be terminated spontaneously before 12-lead ECG is recorded [4,15]. Overlooking a possible arrhythmia may cause a delay in proper first-line treatment for AVNRT and AVRT, for example, vagal manoeuvres as self-management [1,3,5,17,18] and a delay in referral for a cardiologist opinion [14,15]. Patients need information about how their symptoms and quality of life may change following these treatments to enable them to make informed decisions about treatment options [1,18,19].…”

Section: Introductionmentioning

confidence: 99%

“…Following catheter ablation, a significant improvement is observed in a variety of symptoms and quality of life indices [10,13,19], as well as decreases in medical and health care costs [20,21]. However, studies of health care utilization at both HCCs and EDs for outpatients with episodes of tachycardia (potential SVT) are limited [5,15]. Hence, effective management of outpatients with tachycardia may substantially affect the utilization of health care resources [2,21].…”

Section: Introductionmentioning

confidence: 99%

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Health care centre and emergency department utilization by patients with episodes of tachycardia

Nordblom

Boysen

Berglund

et al. 2022

BMC Cardiovasc Disord

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Background Outpatients seek to visit health care facilities for episodes of tachycardia-related signs and symptoms. The challenge for physicians is to balance a proper initial assessment and avoid overlooking a possible arrhythmia. This common clinical situation affects individuals and health care utilization, and effective management may substantially affect health care resources. This study aimed to explore health care utilization for outpatients with episodes of tachycardia visiting health care centres (HCCs) and/or emergency departments (EDs). Method This retrospective study used data of adult outpatients (≥ 18 years) who were assessed by a physician as having a specific or nonspecific diagnosis of arrhythmia between 2017 and 2018, and data were retrieved from medical records and a regional registry database. Data was analysed with appropriate statistical analyses to identify disparities between sex, age and terms of search pattern for each health care facility. Analysis of variance was used to test disparities between the sexes, and one-factor ANOVA was used for the incidence of missed arrhythmias. Results A total of 2719 visits with 2373 outpatients were included in the study. The result showed a significant difference in the total number of visits (n = 2719) between female and male patients (68% vs. 32%, p < .001). In the 60–69- and 70–79-year age groups, females had significantly higher frequencies of visits than males (p = .018). A significant difference was also observed between sexes in terms of which health care facility they tended to visit (p < .001). Ninety-five percent of the outpatients visiting EDs were hospitalized. When estimating the incidence of missed arrhythmias (diagnoses) in relation to assessments, the results showed a 5% missed diagnosis involving potential atrioventricular nodal re-entry tachycardia and atrioventricular re-entry tachycardia. Moreover, the referral rate was low, especially from HCCs to cardiologists. Conclusions This study shows a significant difference in total visits in HCCs and/or EDs by patients of different sexes and indicates the need for improved care for outpatients with episodes of tachycardia. Sex- and age-related differences must be addressed with an aim of providing equal care. Finally, the low rate of referral from HCCs to cardiologists compared to the high proportion of hospitalizations from EDs, deserves further investigation.

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Section: Validation Of Heart-rhythmmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Health care centre and emergency department utilization by patients with episodes of tachycardia

Nordblom

Boysen

Berglund

et al. 2022

BMC Cardiovasc Disord

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show abstract

“…From a statistical perspective, the supraventricular patients are approximately 2.25 per thousand individuals, and its incidence case on an annual basis is about 35 cases per 100,000 people (7). Concerning patients diagnosed with arrhythmias, their average expenditure per year is nearly doubled the amount before diagnosis, thereby conferring a considerable financial burden on the healthcare system (8). SVT is generally treated using the following methods namely: vagal maneuvers, administration of adenosine, intravenous injection of class Ic or class III antiarrhythmic drugs (e.g., propafenone, sotalol, or amiodarone), electrical cardioversion, or catheter ablation (9).…”

Section: Introductionmentioning

confidence: 99%

The Efficacy Comparison Between Guan-Fu Base A Hydrochloric Injection vs. Propafenone Hydrochloric Injection in the Treatment of Arrhythmia: Systemic Review and Meta-Analysis

Song

Tang

Gao

et al. 2021

Front. Cardiovasc. Med.

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Objective: To determine using a systematic assessment and meta-analysis if GFA injection is an appropriate substitute of propafenone for arrhythmic.Design: Conduct a systematic review and meta-analysis of randomized controlled trials.Data Source: PubMed, Web of Science, Cochrane Library, Embase, Wan-Fang Database, VIP, CNKI, and Sino Med from their inception to 7 March 2021.Eligibility Criteria for Selecting Studies: Inclusion of randomized controlled trials, which draws a comparison between GFA and propafenone. Evaluation of study integrity and conducted an extraction of independent data.Main Outcome Measure: Efficacy for supraventricular tachycardia, it is considered effective if it is reversed within 40 min (without considering recurrence); for premature ventricular beats, if they are reduced by more than 50% within 6 h.Results: Included in this current study are 1,294 research subjects pooled from 14 clinical studies. From the pooled assessment, GFA is demonstrated to be the equivalent of propafenone regarding the potency of effectiveness for tachycardia (RR = 1.11, 95% CI: 0.96, 1.28, P = 0.15). The subset analysis indicated that GFA has a better effect on premature ventricular beats (RR = 1.35, 95% CI: 1.07, 1.70, P = 0.01) and a similar effect on supraventricular tachycardia (RR = 1.07, 95% CI: 0.98, 1.12, P = 0.21). GFA effectiveness is lesser than propafenone in the case of mean converting time (WMD = −1.18, 95% CI: −2.30, −0.07, P = 0.04), systolic blood pressure (WMD = −3.53, 95% CI: −6.97, −0.09, P = 0.04), and QRS complex (WMD = −3.82, 95% CI: −6.96, −0.69, P = 0.02). Both GFA and propafenone have identical effects for diastolic blood pressure, heart rate, P-R interval, and QTc interval.Conclusion: A meta-analysis of RCTs was performed across 14 clinical trials, whereby 1,294 patients are used as research subjects. From the results, it is revealed that the effect exhibited by GFA injection is similar to the propafenone injection when treating premature ventricular beats or supraventricular tachycardia. Nevertheless, in certain academic disciplines, it was found that GFA is safer and beneficial compared to propafenone. Based on facts from relevant studies, GFA is deemed applicable during clinical practice.Systematic Review Registration:https://www.inplasy.com/inplasy-2021-3-0077/, identifier: INPLASY202130077.

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Symptom burden guiding invasive electrophysiological study in paroxysmal supraventricular tachycardia: The believe SVT registry

Rodriguez Muñoz,

Ramos Jimenez,

Marco Del Castillo

et al. 2024

American Heart Journal

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Trends in health care resource use and expenditures in patients with newly diagnosed paroxysmal supraventricular tachycardia in the United States

Cited by 7 publications

References 14 publications

Health care centre and emergency department utilization by patients with episodes of tachycardia

Health care centre and emergency department utilization by patients with episodes of tachycardia

The Efficacy Comparison Between Guan-Fu Base A Hydrochloric Injection vs. Propafenone Hydrochloric Injection in the Treatment of Arrhythmia: Systemic Review and Meta-Analysis

Symptom burden guiding invasive electrophysiological study in paroxysmal supraventricular tachycardia: The believe SVT registry

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