OBJECTIVES: Few data are available on longitudinal trends in health resource utilization and expenditures for paroxysmal supraventricular tachycardia (PSVT). We sought to assess the trends in diagnostic testing and expenditures around the time of PSVT diagnosis in a large, nationwide cohort.

METHODS: Adults (age 18 to 65 years) with newly diagnosed PSVT were identified in IBM MarketScan between 1/1/08 and 12/31/16. Patients were observable for three years before and after PSVT diagnosis. PSVT patients were propensity-score matched (1:1) with non-PSVT controls. Over the 6-year period around PSVT diagnosis, trends in the variation in diagnostic testing use and expenditures were evaluated.

RESULTS: Among 24,624 matched patients, PSVT was associated with a higher rate of diagnostic testing (1292 tests per 1000 patient-years [PYs] vs. 313 per 1000 PYs; p<0.001). Diagnostic testing increased leading up to PSVT diagnosis, peaking in the year preceding and the year following PSVT diagnosis and remaining elevated after PSVT diagnosis, relative to matched controls. Among PSVT patients, the most common diagnostic tests were electrocardiograms (878 per 1000 PYs), echocardiograms (205 per 1000 PYs), event monitoring (205 per 1000 PYs), and stress testing (108 per 1000 PYs). Diagnostic testing accounted for 10% of the $12,675 mean annual expenditures for PSVT patients.

CONCLUSIONS: Diagnostic testing was more common in PSVT than non-PSVT patients in both the pre- and post-diagnosis periods. A diagnosis of PSVT is resource intensive and expensive, and further research is required to determine the appropriate frequency of diagnostic testing and optimal patient care pathway.