The Real-World Utility of the LINQ Implantable Loop Recorder in Pediatric and Adult Congenital Heart Patients

Bezzerides, Vassilios J.; Walsh, Amy Z.; Martuscello, Maria; Escudero, Carolina A.; Lam, Geralyn; Abrams, Dominic J.; Triedman, John K.; Alexander, Mark E.; Bevilacqua, Laura; Mah, Douglas Y.

doi:10.1016/j.jacep.2018.09.016

Cited by 38 publications

(26 citation statements)

References 13 publications

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“…This is slightly higher than previous retrospective studies in patients with CHD who received an ICM [19,20]. These studies focused on the overall diagnostic yield of an ICM and not specifically on [19]. In this study, 1 of 34 patients (3%) received an ICD during a median duration of followup of 11.8 months.…”

Section: Risk Stratification Using Icmmentioning

confidence: 69%

“…The incidence of VA was high in this population and resulted in implantation of an ICD for primary prevention in 10% of the study population. This is slightly higher than previous retrospective studies in patients with CHD who received an ICM [19,20]. These studies focused on the overall diagnostic yield of an ICM and not specifically on [19].…”

Section: Risk Stratification Using Icmmentioning

confidence: 70%

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Early detection of ventricular arrhythmias in adults with congenital heart disease using an insertable cardiac monitor (EDVA-CHD study)

Sakhi¹,

Kauling²,

Theuns³

et al. 2020

International Journal of Cardiology

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Background: Sudden cardiac death (SCD) due to ventricular arrhythmias (VA) is an important mode of death in adults with congenital heart disease (CHD). Risk stratification is difficult in this heterogeneous population. Insertable cardiac monitors (ICM) may be useful for risk stratification. The purpose of the present study was to evaluate the use of ICM for the detection of VA in adults with CHD. Methods: In this prospective single-center observational study we included consecutive adults with CHD deemed at risk of VA who received an ICM between March 2013 and February 2019. The decision to implant an ICM was made in a Heart Team consisting of a cardiac electrophysiologist and a cardiologist specialized in CHD. Results: A total of 30 patients (mean age, 38 ± 15 years; 50% male) received an ICM. During a median follow-up of 16 months, 8 patients (27%) had documented nonsustained VA. Of these 8 patients, 3 (10%) received a prophylactic ICD. Furthermore, ICM-detected arrhythmias were present in 22 patients (73%) leading to a change in clinical management in 16 patients (53%). Besides the patients receiving an ICD, 10 patients (33%) had a change in their antiarrhythmic drugs, 6 patients (20%) underwent an electrophysiology study, and 1 patient (3%) received a pacemaker. Conclusions: The detection of VA by the ICM contributed to the clinical decision to implant a prophylactic ICD. Furthermore, ICM-detected arrhythmias led to important changes in the clinical management. Therefore, long-term arrhythmia monitoring by an ICM seems valuable for risk stratification in adults with CHD.

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Section: Risk Stratification Using Icmmentioning

confidence: 69%

Section: Risk Stratification Using Icmmentioning

confidence: 70%

Early detection of ventricular arrhythmias in adults with congenital heart disease using an insertable cardiac monitor (EDVA-CHD study)

Sakhi¹,

Kauling²,

Theuns³

et al. 2020

International Journal of Cardiology

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“…Bezzerides et al reported on 34 patients, mostly children and only a few adults with CHD, aging between 3.6 months to 44.6 years at implantation. Syncope was the most common indication, and the average time to diagnosis was less than 5 months and the ILR provided useful data in more than half of the patients (12).…”

Section: Discussionmentioning

confidence: 99%

Implantable loop recorder for monitoring patients with congenital heart disease

Huntgeburth¹,

Hohmann²,

Ewert³

et al. 2021

Cardiovasc Diagn Ther

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Background: Patients with congenital heart defects (CHD) are prone to residua, sequels and complications from the underlying anomaly, where cardiac arrhythmias are one of the major causes for hospitalization, morbidity and mortality. The importance of the subcutaneous implantable loop recorder (ILR) for the detection and documentation of significant arrhythmias has increased over the last years. To date, however, there is little data on ILR use in the CHD population.Methods: In this single center, retrospective observational study, all CHD-patients with an ILR were identified who were under care of the German Heart Center Munich between February 2015 and January 2019. The primary endpoint of the study was the detection or exclusion of significant arrhythmias during follow-up in CHD-patients who had received an ILR. The secondary endpoint was to determine whether ILR findings influenced patient management, defined as initiation or adjustment of medication, cardioversion, electrophysiologic study, catheter ablation, or implantation of cardiac implantable electronic devices (CIEDs) such as pacemakers (PM) or implantable cardioverter-defibrillators.Results: An ILR was implanted in 33 CHD-patients (mean age, 43±20 years; 42.4% female) with CHD.During a mean observation period of 697±433 days, clinically relevant arrhythmias, correlating with the patients' complaints and symptoms, were detected in 19 patients (59.4%), encompassing supraventricular tachycardia (n=10), supraventricular or ventricular ectopic beats (n=10), non-sustained ventricular tachycardia (n=2), ventricular tachycardia (n=2), and bradycardia (n=2). In 9 patients (28.1%) the detected arrhythmia was considered an event requiring treatment. Treatment modalities included catheter ablation (n=5), modification of antiarrhythmic drug regime (n=2), adaptation of anticoagulation therapy (n=2), or implantation of a subcutaneous ICD (n=1). Regarding the occurrence of cardiac arrhythmias or a related need for therapeutic intervention, no significant differences were identified with respect to WHO functional class, the presence of pulmonary arterial hypertension or reduced resting peripheral oxygen saturation.

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“…ICM, along with Holter monitoring, external loop recorders, and remote at-home telemetry, are reported to provide a diagnostic yield of 43%-50% at 2 years and 80% at 4 years. [221][222][223][224][225][226]…”

Section: Insertable Cardiac Monitorsmentioning

confidence: 99%

2021 PACES Expert Consensus Statement on the Indications and Management of Cardiovascular Implantable Electronic Devices in Pediatric Patients

et al. 2021

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The Real-World Utility of the LINQ Implantable Loop Recorder in Pediatric and Adult Congenital Heart Patients

Cited by 38 publications

References 13 publications

Early detection of ventricular arrhythmias in adults with congenital heart disease using an insertable cardiac monitor (EDVA-CHD study)

Early detection of ventricular arrhythmias in adults with congenital heart disease using an insertable cardiac monitor (EDVA-CHD study)

Implantable loop recorder for monitoring patients with congenital heart disease

2021 PACES Expert Consensus Statement on the Indications and Management of Cardiovascular Implantable Electronic Devices in Pediatric Patients

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