A Review of the Wide Range of Indications and Uses of Implantable Loop Recorders: A Review of the Literature

Kwok, Chun Shing; Darlington, Daniel N.; Mayer, Joseph; Panchal, Gaurav; Walker, Vincent; Zachariah, Donah; Phan, Thanh Trung; Mallen, Christian; Barker, Diane; Patwala, Ashish

doi:10.3390/hearts3020007

Cited by 10 publications

(6 citation statements)

References 35 publications

(35 reference statements)

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“…This kind of person needs continuous cardiac monitoring to detect dangerous changes since their beginning. Implanted cardiac loop recorders could be a solution for persons suffering from this situation, but these devices and the associated surgery procedure are expensive [11]. Besides, the risk associated with any surgery is always present.…”

Section: Cardiac Monitoring Of High-risk Personsmentioning

confidence: 99%

Low-cost Approaches to Follow-up Cardiac Patients in Low-Income Countries Using Public Data Networks

Gonzalez-Fernandez¹,

Mulet-Cartaya²,

Oca-Colina³

et al. 2023

Biomedical Engineering

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The main characteristics of three approaches to cardiac care using public data networks are presented. All efforts were addressed to get minimum-cost solutions for low-budget public health systems. The first solution was developed to follow-up arrhythmic patients between medical consultations, setting a more closed patient-physician relationship, and a daily recording of cardiac rhythm changes. It is based on a personal battery-powered device for one-channel ECG recording, minimizing electrode setting and operation complexity. An ECG recording taken daily allows a detailed analysis anytime without the patient’s traveling to a health institution. A second solution was aimed at monitoring high-risk cardiac patients. A 24-h portable device capable of monitoring heart rate and sudden falls, typically associated with cardiac syncope, was developed. When any cardiac event or fall is detected, an urgent message is sent to relatives and the medical emergency care system asking for help. The third system implemented is oriented to the study of different cardiac parameters in people who suffer from heart disease or in those who are prone to suffering from it. Twelve-lead ECG is recorded periodically by each patient and trend graphics reflect ECG parameters strongly associated with cardiac disturbances, such as sudden death and ischemia. This approach allows the detection of the first troubling electrocardiographic deviations, making possible early medical intervention.

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Section: Cardiac Monitoring Of High-risk Personsmentioning

confidence: 99%

Low-cost Approaches to Follow-up Cardiac Patients in Low-Income Countries Using Public Data Networks

Gonzalez-Fernandez¹,

Mulet-Cartaya²,

Oca-Colina³

et al. 2023

Biomedical Engineering

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“…ICMs record single-channel subcutaneous ECGs (sECG) of detected arrhythmias which can be transmitted via remote monitoring to clinicians. ICMs are used in various challenging diagnostic areas ( 1 ) and the ICM follow-up burden is significant ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Implantable cardiac monitors: artificial intelligence and signal processing reduce remote ECG review workload and preserve arrhythmia detection sensitivity

Bisignani,

Cheung,

Rordorf

et al. 2024

Front. Cardiovasc. Med.

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IntroductionImplantable cardiac monitors (ICMs) provide long-term arrhythmia monitoring, but high rates of false detections increase the review burden. The new “SmartECG” algorithm filters false detections. Using large real-world data sets, we aimed to quantify the reduction in workload and any loss in sensitivity from this new algorithm.MethodsPatients with a BioMonitor IIIm and any device indication were included from three clinical projects. All subcutaneous ECGs (sECGs) transmitted via remote monitoring were classified by the algorithm as “true” or “false.” We quantified the relative reduction in workload assuming “false” sECGs were ignored. The remote monitoring workload from five hospitals with established remote monitoring routines was evaluated. Loss in sensitivity was estimated by testing a sample of 2000 sECGs against a clinical board of three physicians.ResultsOf our population of 368 patients, 42% had an indication for syncope or pre-syncope and 31% for cryptogenic stroke. Within 418.5 patient-years of follow-up, 143,096 remote monitoring transmissions contained 61,517 sECGs. SmartECG filtered 42.8% of all sECGs as “false,” reducing the number per patient-year from 147 to 84. In five hospitals, nine trained reviewers inspected on average 105 sECGs per working hour. This results in an annual working time per patient of 83 min without SmartECG, and 48 min with SmartECG. The loss of sensitivity is estimated as 2.6%. In the majority of cases where true arrhythmias were rejected, SmartECG classified the same type of arrhythmia as “true” before or within 3 days of the falsely rejected sECG.ConclusionSmartECG increases efficiency in long-term arrhythmia monitoring using ICMs. The reduction of workload by SmartECG is meaningful and the risk of missing a relevant arrhythmia due to incorrect filtering by the algorithm is limited.

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“…[3] Mechanical rigidity of lifesaving devices (Figure S1, Supporting Information), such as pacemakers and implantable cardioverter defibrillators, leads to non-ideal interfaces with soft tissues causing various complications (Table S1, Supporting Information). [4,5] As a result, conformal devices melding to the curvilinear topology of the beating heart are desired.…”

Section: Introductionmentioning

confidence: 99%

Graphene Biointerface for Cardiac Arrhythmia Diagnosis and Treatment

et al. 2023

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Heart rhythm disorders, known as arrhythmias, cause signi cant morbidity and are one of the leading causes of mortality. Cardiac arrhythmias are primarily treated by implantable devices, such as pacemakers and de brillators, or by ablation therapy guided by electroanatomical mapping.Pharmacological treatments are mostly ineffective. Both implantable and ablation therapies require sophisticated biointerfaces for electrophysiological measurements of electrograms and delivery of therapeutic stimulation or ablation energy. In this work, we report for the rst time on graphene biointerface for in vivo cardiac electrophysiology. Leveraging sub-micrometer thick tissue-conformable graphene arrays, we demonstrate sensing and stimulation of the open mammalian heart both in vitro and in vivo. Furthermore, we demonstrate graphene pacemaker treatment of a pharmacologically-induced arrhythmia, AV block. The arrays show effective electrochemical properties, namely interface impedance down to 40 Ohm×cm 2 , charge storage capacity up to 63.7 mC/cm 2 , and charge injection capacity up to 704 µC/cm 2 . Transparency of the graphene structures allows for simultaneous optical mapping of cardiac action potentials and calcium transients while performing electrical measurements and stimulation. Our report presents evidence of the signi cant potential of graphene biointerfaces for the future clinical device-and catheter-based cardiac arrhythmias therapies.

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A Review of the Wide Range of Indications and Uses of Implantable Loop Recorders: A Review of the Literature

Cited by 10 publications

References 35 publications

Low-cost Approaches to Follow-up Cardiac Patients in Low-Income Countries Using Public Data Networks

Low-cost Approaches to Follow-up Cardiac Patients in Low-Income Countries Using Public Data Networks

Implantable cardiac monitors: artificial intelligence and signal processing reduce remote ECG review workload and preserve arrhythmia detection sensitivity

Graphene Biointerface for Cardiac Arrhythmia Diagnosis and Treatment

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