Outcomes differed across ACM modalities and vendors, with a specific LTCM (iRhythm) associated with higher claims-based arrhythmia yield and lower repeat monitoring than most alternatives, and with lower hospitalization, health care utilization, and costs.
Compared with iRhythm LTCM, Holter, MCT, and other LTCM had lower odds of arrhythmia diagnosis within 90 days.
Repeat monitoring within 180 days was higher for patients receiving other LTCM, AEM, and Holter compared with iRhythm LTCM.
All other ACM modalities had significantly higher odds of cardiovascular events within 365 days compared with iRhythm LTCM.
All other ACM modalities were associated with significantly higher odds of hospitalization within 365 days compared with iRhythm LTCM.
All other ACM modalities were associated with significantly higher odds of emergency department visits within 365 days compared with iRhythm LTCM.
All other ACM modalities were associated with significantly higher healthcare costs within 365 days compared with iRhythm LTCM.
The study population comprised 352,782 patients receiving first ACM use between January 1, 2017 and June 30, 2022.
This research examined how different types of wearable heart monitors perform in real-world clinical practice by analyzing insurance claims data from over 352,000 patients. The monitors studied included long-term continuous monitors (LTCM, such as patch monitors), traditional Holter monitors, ambulatory event monitors (AEM), and mobile cardiac telemetry (MCT). The study compared outcomes like whether an abnormal heart rhythm was detected, whether patients needed to repeat monitoring, and whether patients ended up in the hospital or emergency department within the following year. This research suggests that the specific brand of monitor used matters, not just the monitor type. Patients who used a specific long-term continuous monitor (made by iRhythm Technologies) were more likely to receive an arrhythmia diagnosis within 90 days and less likely to need repeat monitoring compared to most other monitor types. Importantly, patients using other monitor types also had higher rates of hospitalization, emergency department visits, cardiovascular events, and overall healthcare costs over the following year compared to those using the iRhythm device. The findings are based on a retrospective analysis of insurance claims rather than a randomized clinical trial, so other factors not fully captured in claims data could influence results. Nevertheless, the study confirms and extends similar findings previously observed in other patient populations, suggesting that the choice of ambulatory cardiac monitor may have meaningful downstream consequences for patient outcomes and healthcare resource use.
Mittal S, Reynolds M, Hughes A, Buysman E, Hendrickson E, Boyle K, et al.. (2026). Comparative Clinical Outcomes Across Ambulatory Cardiac Monitoring Modalities.. Clinical cardiology. https://doi.org/10.1002/clc.70500