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An audit of utilisation of Holter tape facilities at Glasgow Royal Infirmary
M L Sedgewick1, I Khalid, M Cunningham
1Department of Medical Cardiology, Royal Infirmary, Glasgow.
Insights
Holter tape analysis is a cost-effective method for assessing heart rhythm over extended periods. This study found the service is likely underutilized, with most recordings not detecting significant arrhythmias but often helping to exclude them.
Area of Science:
- Cardiology
- Medical Diagnostics
- Health Services Research
Background:
- Holter tape analysis is a standard diagnostic tool for identifying cardiac arrhythmias.
- Understanding the utilization patterns and diagnostic yield of Holter monitoring services is crucial for optimizing healthcare resource allocation.
Purpose of the Study:
- To evaluate the utilization of the Holter monitoring service at Glasgow Royal Infirmary over a six-month period.
- To assess the diagnostic yield and turnaround time of Holter tape analysis.
- To determine the cost-effectiveness of the Holter service.
Main Methods:
- Retrospective analysis of 305 Holter tapes recorded over six months.
- Data collection included referral source, delay from request to dispatch, and diagnostic findings.
- Capital cost per tape was calculated.
Main Results:
- 95% of requests originated from outpatient referrals.
- Median delay from request to dispatch was 14 days.
- No arrhythmia was detected in 77% of recordings; 3% showed significant symptomatic arrhythmias.
- Relevant arrhythmias were detected in 17% of cases, and possible arrhythmias were excluded in 61%.
Conclusions:
- Holter monitoring is an inexpensive method for extended heart rhythm analysis.
- The service appears to be underutilized.
- While often negative for significant arrhythmias, Holter monitoring is valuable for excluding potential cardiac rhythm disorders.
Abstract:
Holter tape analysis is widely used to both confirm and exclude the presence of significant arrhythmias. We have studied the utilisation of the Holter service at Glasgow Royal Infirmary over a period of 6 months. During this period 305 x 24 hour Holter tapes were recorded. Out patient referrals generated 95% of these requests with only 5% of requests for in patient recordings. The median delay from request date to dispatch to the referring doctor was 14 days. No arrhythmia was detected in 77% and only 3% had a detectable symptomatic significant arrhythmia. The recording was felt to demonstrate the presence of a relevant arrhythmia in 17% of cases and to help exclude a possible arrhythmia in 61%. The capital cost per tape was 20.82 Pounds. In conclusion Holter monitoring is an inexpensive way of analysing the heart rhythm over an extended period which is probably underused.