Practice-specific process improvement interventions in diagnosis and adoption of pacemaker therapy in SND patients: Results from IMPROVE Brady study

IMPROVE Brady was a quality improvement initiative conducted at ten centers in India and Bangladesh for patients with SND. This prospective, multicenter study enrolled patients in two phases sequentially (Phase I and II) with a heart rate of ≤50 beats per minute presenting with symptoms including syncope, dizziness, and/or dyspnea. Patients were followed to identify the proportion diagnosed with symptomatic SND who received pacemaker therapy (IPG device). In Phase I, physicians assessed and treated subjects per standard care practice at their center. Prior to enrollment of Phase II, the investigators completed an educational workshop and were given access to the IMPROVE Brady toolkit (including patient and physician educational tools) to create a practice-specific process improvement intervention. The prespecified primary objectives were to evaluate the impact of the intervention on (1) the diagnosis of SND and (2) whether SND subjects receive an indicated IPG device.