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Patient selection for ambulatory cardiac monitoring in the Indian healthcare environment
  1. Maneesh Shrivastav1,
  2. Rajendra Shrivastav2,
  3. Jitendra Makkar3,
  4. Mauro Biffi4
  1. 1India Medtronic Private Limited, Mumbai, Maharashtra, India
  2. 2Private Surgical Practice, Pontiac, Illinois, USA
  3. 3Department of Cardiology, Fortis Escorts Hospital, Jaipur, India
  4. 4Institute of Cardiology, University of Bologna, Bologna, Italy
  1. Correspondence to Dr Maneesh Shrivastav, India Medtronic Private Limited, 1241Solitaire Corporate Park, Andheri-Ghatkopar Link Road, Andheri East, Mumbai 400 093, India; maneesh{at}ieee.org

Abstract

Cardiovascular disease (CVD) in India comprises the bulk of non-communicable diseases, resulting in 2 million deaths per year. The incidence of CVD in India is estimated to be up to four times higher than in other countries. Though the quantification of the prevalence of rhythm disorders in India is not available, it can be inferred to be proportionately high. Identification and treatment of arrhythmia is limited by several socioeconomic factors including low health insurance penetration, limited reimbursement and high out-of-pocket expenditures. Thus, there exists a need in India to (1) select an appropriate tool that is both high yielding and cost effective and (2) employ a suitable patient selection method. This paper focuses on these two aspects for cardiac arrhythmia diagnosis using ambulatory monitoring technology, while keeping in mind the dynamics of the Indian healthcare setting.

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