{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T15:17:58Z","timestamp":1793287078917,"version":"4.5.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,8,16]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Insertable cardiac monitors (ICMs) are effective in the detection of paroxysmal arrhythmias. In 2014, the first miniaturized ICM was introduced with a less invasive implant technique. The impact of this technology on ICM use in pediatric patients has not been evaluated. We hypothesized an increase in annual pediatric ICM implants starting in 2014 attributable to device miniaturization.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A retrospective observational study was conducted using administrative claims from MarketScan Medicaid and commercial insurance claims databases. Use of ICM between January 2013 and December 2018 was measured (normalized to the total enrolled population \u226418\u2009years) and compared with balancing measures (Holter ambulatory monitors, cardiac event monitors, encounters with syncope diagnosis, implantation of implantable cardioverter\u2010defibrillator\/pacemaker). Secondary analyses included evaluations of subsequent interventions and complications. The study cohort included 33\u2009532\u2009185 individual subjects, of which 769 (0.002%) underwent ICM implantation. Subjects who underwent ICM implantation were 52% male sex, with a median age of 16\u2009years (interquartile range, 10\u201317\u2009years). A history of syncope was present in 71%, palpitations in 43%, and congenital heart disease in 28%. Following release of the miniaturized ICM, use of ICMs increased from 5 procedures per million enrollees in 2013 to 11 per million between 2015 and 2018 (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), while balancing measures remained static. Of 394 subjects with \u22651\u2009year of follow\u2010up after implantation, interventions included catheter ablation in 24 (6%), pacemaker implantation in 15 (4%), and implantable cardioverter\u2010defibrillator implantation in 7 (2%).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Introduction of the miniaturized ICM was followed by a rapid increase in pediatric use. The effects on outcomes and value deserve further attention.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.024112","type":"journal-article","created":{"date-parts":[[2022,8,5]],"date-time":"2022-08-05T09:16:11Z","timestamp":1659690971000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of Device Miniaturization on Insertable Cardiac Monitor Use in the Pediatric Population: An Analysis of the MarketScan Commercial and Medicaid Databases"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0187-0668","authenticated-orcid":false,"given":"Dustin","family":"Nash","sequence":"first","affiliation":[{"name":"Division of Cardiology The Children\u2019s Hospital of Philadelphia PA"},{"name":"Department of Pediatrics The Perelman School of Medicine at The University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Katcoff","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Children\u2019s Hospital of Philadelphia PA"},{"name":"Department of Pediatrics The Perelman School of Medicine at The University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8019-0646","authenticated-orcid":false,"given":"Jennifer","family":"Faerber","sequence":"additional","affiliation":[{"name":"Data Science and Biostatistics Unit The Children\u2019s Hospital of Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. Ramesh","family":"Iyer","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Children\u2019s Hospital of Philadelphia PA"},{"name":"Department of Pediatrics The Perelman School of Medicine at The University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maully J.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Children\u2019s Hospital of Philadelphia PA"},{"name":"Department of Pediatrics The Perelman School of Medicine at The University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6023-1634","authenticated-orcid":false,"given":"Michael L.","family":"O'Byrne","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Children\u2019s Hospital of Philadelphia PA"},{"name":"Department of Pediatrics The Perelman School of Medicine at The University of Pennsylvania Philadelphia PA"},{"name":"Center for Pediatric Clinical Effectiveness The Children\u2019s Hospital of Philadelphia PA"},{"name":"Leonard Davis Institute and Cardiovascular Outcomes, Quality, and Evaluative Research Center University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1477-6446","authenticated-orcid":false,"given":"Christopher","family":"Janson","sequence":"additional","affiliation":[{"name":"Division of Cardiology The Children\u2019s Hospital of Philadelphia PA"},{"name":"Department of Pediatrics The Perelman School of Medicine at The University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.112.3.e228"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2008.00995.x"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.04.057"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12866"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.02.030"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2018.09.016"},{"key":"e_1_3_1_8_2","unstructured":"The Truven Health MarketScan Databases for Health Services Researchers. truvenhealth.commarketslife\u2010sciencesproductsdata\u2010toolsmarketscan\u2010databases. 1\u201315."},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3849"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.08.2178"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302744"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-3100"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-2462"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.013450"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/2045894020933083"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2020.10.058"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-021-02543-y"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euv217"},{"key":"e_1_3_1_19_2","unstructured":"Cardiac monitors\u2014LINQ II. 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