Health care utilization among adenosine-sensitive supraventricular tachycardia patients presenting to the emergency department

Thomas Dewland, Adam Oesterle, John Stein, Gregory M. Marcus

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Purpose: Although adenosine-sensitive supraventricular tachycardia (SVT) is generally curable, it remains an important cause of healthcare utilization. We sought to determine predictors of health care utilization among SVT patients presenting to the emergency department (ED). Methods: We studied consecutive patients evaluated in an urban, academic ED for adenosine-sensitive SVT. The primary study outcomes were (1) ambulance transportation to the index ED visit, (2) hospital admission from the index ED encounter, and (3) recurrent SVT-associated ED encounters. Results: Among 100 patients with adenosine-sensitive SVT, 35 were transported to the ED by ambulance. Prior electrophysiologist evaluation was associated with a significant 87% reduced odds of ambulance utilization (OR 0.13, 95% CI 0.03–0.67, p = 0.015). A total of 62 patients were subsequently admitted to the hospital. All patients with coronary artery disease, diabetes, syncope, and wide complex SVT were admitted. Similarly, individuals with an elevated troponin had a significantly greater odds of hospital admission (OR 16.8, 95% CI 1.9–148.4, p = 0.011). After the index ED visit, 60 patients were seen by an electrophysiologist, and 47 underwent catheter ablation. Individuals treated with catheter ablation had a significant 75% reduction in the risk of a recurrent ED visit for SVT (HR 0.25, 95% CI 0.10–0.62, p = 0.003). Conclusions: Readily modifiable clinical factors, including a previous visit to an electrophysiologist and treatment with catheter ablation, are associated with reduced health care utilization among patients presenting to the ED with SVT.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalJournal of Interventional Cardiac Electrophysiology
DOIs
StateAccepted/In press - Jun 10 2017

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Keywords

  • Adenosine
  • Catheter ablation
  • Emergency department
  • Healthcare utilization
  • Supraventricular tachycardia
  • SVT

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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