title: Follow-up of patients with new cardiovascular implantable electronic devices: are experts' recommendations implemented in routine clinical practice?
abstract: BACKGROUND
  A 2008 expert consensus statement outlined the minimum frequency of follow-up of patients with cardiovascular implantable electronic devices (CIEDs).
  
  
  RESULTS
  We studied 38 055 Medicare beneficiaries who received a new CIED between January 1, 2005, and June 30, 2009. The main outcome measure was variation of follow-up by patient factors and year of device implantation. We determined the number of patients who were eligible for and attended an in-person CIED follow-up visit within 2 to 12 weeks, 0 to 16 weeks, and 1 year after implantation. Among eligible patients, 42.4% had an initial in-person visit within 2 to 12 weeks. This visit was significantly more common among white patients than black patients and patients of other races (43.0% versus 36.8% versus 40.5%; P<0.001). Follow-up within 2 to 12 weeks improved from 40.3% in 2005 to 55.1% in 2009 (P<0.001 for trend). The rate of follow-up within 0 to 16 weeks was 65.1% and improved considerably from 2005 to 2009 (62.3%-79.6%; P<0.001 for trend). Within 1 year, 78.0% of the overall population had at least 1 in-person CIED follow-up visit.
  
  
  CONCLUSIONS
  Although most Medicare beneficiaries who received a new CIED between 2005 and 2009 did not have an initial in-person CIED follow-up visit within 2 to 12 weeks after device implantation, the rate of initial follow-up improved appreciably over time. This CIED follow-up visit was significantly more common in white patients than in patients of other races.
authors.affiliation: Duke Clinical Research Institute, Department of Medicine, Duke University School of Medicine, Durham, NC 27715, USA. alkha001@mc.duke.edu
authors.forename: Sana M
authors.initials: SM
authors.lastname: Al-Khatib
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Mi
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Wilkoff
authors.forename: Laura G
authors.initials: LG
authors.lastname: Qualls
authors.forename: Camille
authors.initials: C
authors.lastname: Frazier-Mills
authors.forename: Soko
authors.initials: S
authors.lastname: Setoguchi
authors.forename: Paul L
authors.initials: PL
authors.lastname: Hess
authors.forename: Lesley H
authors.initials: LH
authors.lastname: Curtis
mesh_terms: D001741:Black or African American; D000359:Aftercare / Q000639:trends*; D000368:Aged; D000369:Aged, 80 and over; D058406:Cardiac Resynchronization Therapy; D058409:Cardiac Resynchronization Therapy Devices; D016009:Chi-Square Distribution; D003266:Continuity of Patient Care / Q000639:trends*; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000639:trends; D006801:Humans; D008297:Male; D006278:Medicare; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D044465:White People