Key result
14-day ePatch cuts costs per detected AF up to ~6-fold versus ILR after cryptogenic stroke.
Why the study?
Patients with cryptogenic stroke may benefit from extended cardiac monitoring for earlier AF detection, but the clinical and cost outcomes of mid-term monitors versus implantable loop recorders across different European healthcare settings were not established.
Does 14-day ePatch extended wear Holter reduce total costs compared to implantable loop recorder in adult patients with cryptogenic stroke?
Does 14-day ePatch extended wear Holter reduce total costs compared to implantable loop recorder in adult patients with cryptogenic stroke?
In a cost-minimization model, 14-day ePatch monitoring was a cost-saving alternative to implantable loop recorders for detecting atrial fibrillation in cryptogenic stroke patients.
Answers are grounded in this paper and cite their sources.
May reduce AF detection costs in cryptogenic stroke; leaves open need for outcome trials before practice change.
Background: Patients who have experienced a cryptogenic stroke (CS) may benefit from extended monitoring and possible earlier detection of atrial fibrillation (AF), allowing for the timely initiation of appropriate pharmacotherapy. Objective: This economic study aimed to evaluate the clinical and cost outcomes of using mid-term cardiac monitors (referred to as "ePatch") versus ILR-only in post-CS patients in the UK, Netherlands (NL) and Sweden. Methods: An existing cost-minimization model was modified to fit healthcare settings in the UK, Netherlands and Sweden. The model's target population was composed of adult patients who had previously experienced a CS, but had no documented history of AF. The model compares the one-year direct medical costs between two groups: one group receiving wearable ePatch, the other group proceeding directly to ILR. Results: When applied to a group of 1,000 patients, the ePatch versus ILR approach resulted in cost savings, due to combination of reduced expenses and decreased modelled occurrence of recurrent strokes in all three countries studied. In the base case analysis, the cost savings per patient with detected AF for ePatch ranged from 3.4-6.0 times, depending on the country. Conclusion: Utilizing ePatch extended wear Holter for mid-term ECG monitoring in CS patients represents a cost-saving alternative to monitoring with ILR. The cost savings were achieved by reducing device expenses and by prevention of recurrent strokes via earlier anticoagulation initiation. Preventing recurrent strokes in this population is highly significant, as it can lead to improved long-term health outcomes and reduced overall healthcare costs.
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Lukyanov et al. (2024) studied Cryptogenic stroke (n=1,000). ePatch vs. Implantable Loop Recorder (ILR) was evaluated on Difference in total costs between the ePatch and ILR-only groups for a cohort of 1,000 patients. Utilizing a 14-day ePatch for mid-term ECG monitoring in cryptogenic stroke patients resulted in cost savings per patient with detected atrial fibrillation ranging from 3.4 to 6.0 times compared to an implantable loop recorder.
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