Annals of Medicine Research and Public Health (ISSN: 2995-5955) | Volume 5, Issue 2 | Editorial Article | Open Access DOI
Pierantonio Russo*
Russo P., MD*; Nathan R., PhD*; Boyle K., DC*; Hendrickson E., PhD**; Wright B., RN, Dr PH*
*EVERSANA LLC, Overland Park, KS, USA
**iRhythm Technologies, San Francisco, CA, USA
*Correspondence to: Pierantonio Russo
Fulltext PDFAmbulatory cardiac monitoring (ACM) is recommended for the evaluation of unexplained symptoms, and its value has traditionally been assessed primarily by diagnostic yield. Far less attention has been paid to whether monitoring before the diagnosis of a major arrhythmia, such as atrial fibrillation, atrial flutter, supraventricular tachycardia, or ventricular tachycardia, influences subsequent patient outcomes. Our real-world claims analyses across commercially insured populations, Medicare beneficiaries, and disease-specific cohorts have consistently shown associations between ACM, particularly longer-duration continuous monitoring, and fewer subsequent hospitalizations, readmissions, and emergency department visits, as well as lower health care costs after arrhythmia is diagnosed. These studies evaluated health care utilization rather than clinical complications, and in one large Medicare comparison, differences in diagnostic yield did not translate into differences in subsequent outcomes. This editorial place these findings in the context of guideline-based indications for ACM and trials of atrial fibrillation screening, while examining the potential biases that could account for the observed associations. We further quantify the robustness of these associations to unmeasured confounding using E-values. The definitive question, however, remains unresolved: does earlier diagnosis of major arrhythmias, particularly atrial fibrillation, reduce the risk of heart failure, myocardial infarction, stroke, and cardiac death? Answering this question will require additional evidence from rigorous target-trial emulation and pragmatic randomized trials.
Ambulatory electrocardiography; Atrial fibrillation; Arrhythmia; Real-world evidence; Health care utilization
Russo P, Nathan R, Boyle K, Hendrickson E, Wright B . Post-Diagnosis Complications in Adults with Major Arrhythmia: Impact of Ambulatory Cardiac Monitoring. Ann Med Res Pub Health. 2026;5(2):1-5.