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Evaluation of a direct access cardiac arrhythmia monitoring service

Skipsey, David A.; Dawson, Fiona M.; Breen, Cathal; Leslie, Stephen J.


David A. Skipsey

Fiona M. Dawson

Stephen J. Leslie


Background: This paper describes the clinical outcomes from a novel direct access arrhythmia monitoring service.

Methods: The study was carried out in the north of Scotland. Data was collected over a 29 month period between 18 June 2008 and 8 November 2010 from consecutive cases from two groups of patients, general practitioner (GP) direct access and 'redirected' consultant referrals. Monitor test results, frequency of arrhythmias requiring further care and clinic attendances were recorded. Statistical differences were analyzed using x2 Fisher's and Student's t-test as appropriate with the significance taken at the 0.05 level.

Results: 239 patients were referred from 47 GP practices. There were 165 (69%) referrals through the 'direct' and 72 (31%) through the 'redirected' route. The average age was 55.5 ± ± 16.7 years with 84 (35.1%) males. 127 (53.1%) had a patient activated event recording and the remaining 112 (46.9%) had Holter monitoring. Of the 239 patients, only nine (3.8%) cases required referral to a consultant cardiologist. Of these, three were directly returned to GP care without consultant clinic review. Six patients with significant arrhythmias were reviewed at cardiology clinic. There were no adverse events.

Conclusions: Direct access for cardiac arrhythmia monitoring seems to provide an effective mechanism for diverting inappropriate or non-essential referrals away from the cardiology clinic

Journal Article Type Article
Acceptance Date Sep 22, 2011
Online Publication Date Jan 1, 2012
Publication Date Jan 1, 2012
Deposit Date Nov 3, 2022
Print ISSN 0008-6312
Publisher Karger Publishers
Peer Reviewed Peer Reviewed
Volume 19
Issue 1
Pages 70-75
Keywords direct access, arrhythmia monitoring, primary care
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