iRhythm Long-Term Cardiac Monitor Improves Arrhythmia Detection, Lowers Costs
Key Clinical Summary
- Study Design: Retrospective cohort of 428 707 commercially insured US adults receiving their first ambulatory cardiac monitor (ACM) between 2016–2023.
- Findings: iRhythm’s long-term continuous monitor (LTCM) identified more arrhythmias, reduced repeat testing, and lowered cardiovascular (CV) events and health care costs vs other ACMs.
- Implication: High-performing LTCMs could improve diagnostic efficiency and value-based care in arrhythmia management.
A new real-world analysis published in The American Journal of Managed Care examined differences in clinical and economic outcomes among major ambulatory cardiac monitors (ACMs) used for arrhythmia detection. Using a large national claims database of commercially insured patients, investigators found that iRhythm’s long-term continuous monitor (LTCM) outperformed other ACM types and manufacturers in diagnostic yield, cardiovascular outcomes, and overall health care costs.
Study Findings
The retrospective cohort included 428 707 adults (mean age 47–49 years) who received an ACM for the first time between 2016 and 2023. Among them, 36% used LTCMs, 36% Holter monitors, and 27% external event monitors (AEMs). Within the LTCM group, 62% used iRhythm’s device.
After inverse probability of treatment weighting to balance covariates, iRhythm’s LTCM demonstrated superior performance:
- Arrhythmia diagnosis: 26.5% vs 18.4% (non-iRhythm LTCM), 14.7% (Holter), and 17.0% (AEM); median time to diagnosis 9 days vs 21–30 days for other devices.
- Retesting: 3.1% vs 5.6% (non-iRhythm LTCM) and 6.2% (Holter); slightly higher than AEMs (2.8%).
- CV events: 11.2% for iRhythm vs 13–15% for others, with a longer median time to event (54 vs 34–38 days).
- Health care costs: Median annual follow-up costs were lowest with iRhythm ($6426) compared with non-iRhythm LTCMs ($6779), AEMs ($7274), or Holters ($6677).
LTCM utilization increased markedly over the study period—from 11% in 2017 to 56% in 2023—while Holter and AEM use declined.
Clinical Implications
These findings highlight how extended continuous cardiac monitoring can enhance diagnostic accuracy and streamline care. Earlier and more precise detection of arrhythmias enables timely interventions, potentially reducing downstream events such as stroke or heart failure.
The results also emphasize the economic advantages of effective monitoring technologies—fewer retests, shorter hospital stays, and reduced all-cause health care costs. For payers and health systems, integrating high-performing LTCMs like iRhythm’s into value-based care models could align quality improvement with cost containment.
Although retrospective, the data extend prior Medicare analyses to a younger, commercially insured population, reinforcing that device choice materially affects outcomes and expenditures in arrhythmia detection.
Conclusion
Among commercially insured adults, iRhythm’s long-term continuous monitor provided faster, more accurate arrhythmia detection with fewer CV events and lower costs than other ACMs. The findings support broader adoption of high-performing LTCMs to enhance patient outcomes and efficiency in real-world cardiac care.
Reference
Russo P, Coetzer H, Hendrickson EM, et al. Assessment of variation in ambulatory cardiac monitoring among commercially insured patients. Am J Manag Care. 2025;32(2). Published online ahead of print August 13, 2025. Accessed November 12, 2025. https://www.ajmc.com/view/assessment-of-variation-in-ambulatory-cardiac-monitoring-among-commercially-insured-patients
