Cost-effectiveness Analysis of Event Recorder as Compared with Holter Monitoring in Patients with Suspected Arrhythmias

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  • 不整脈疾患におけるホルター心電図に対するイベントレコーダーの費用対効果分析

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Background : Although self-activating cardiac event recorders are available, the cost-effectiveness of such event recorders remains unclear in this country. Objectives : This study was performed for cost-effectiveness analysis of event recorder (EP-202, Parama-Tech Co. Ltd., Japan) as compared with conventional Holter monitoring (cardiomemory EMC, Nihon Kohden, Japan). Methods : Consecutive 107 patients with suspected arrhythmias were enrolled in this study from 2007 to 2009. They underwent either event recorder (n=44) or Holter ECG (n=48) at the discretion of treating physicians, after recording standard 12-lead ECG. Diagnostic cost was calculated as 1,500 points for the Holter ECG and 150 points for the event recorder according to the health insurance system. Effectiveness was evaluated as number of patients whose arrhythmias were diagnosed by either ECG modality and were indicative of pharmacologic or nonpharmacologic therapies. Results : The average cost in patients undergoing Holter ECG was higher than that of the event recorder by about one-order (p<0.001), whereas these modalities yielded equivalent diagnostic abilities of 39.6%and 56.8%, respectively (p = 0.39). Conclusions : Event recorder is more cost-effective than Holter monitoring for arrhythmia detection, especially in the case of symptomatic and infrequent paroxysms of various kinds of arrhythmias.

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