9. Heart Rate Control Using Implantable Devices. What We Have Achieved And What Else Is Waiting In Modern Arhythmology? Review
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Abstract
Ambulatory cardiac monitoring is a rapidly expanding field of functional diagnostics. Today, the main direction of car-diac monitoring is outpatient monitoring of the electrocardiogram, an important diagnostic tool that is used daily by doctors in many specialties. Therefore, both wearable and subcutaneous technologies of electrocardiographic monitoring are now widely used. A number of devices can be placed under the patient’s skin and have the ability to wirelessly transmit data to home transmitters, which, in turn, then transmit data to the doctor via cloud interfaces, so that, they allow remote monitor-ing and monitoring of the patient’s condition. Such systems are widely used in various countries of the world, approved in the USA, and are also used for remote monitoring of patients in Europe and Kazakhstan, where their implementation is gaining momentum. This review presents the technical aspects of subcutaneous monitoring, provides a schematic repre-sentation of the operation of systems existing on the market, discusses the advantages of this method, as well as the disad-vantages of existing implantable cardiac monitors. The issues of the future development of this technology and indications for the use of existing devices approved by the professional cardiological communities are considered.
Keywords
ambulatory cardiac monitoring, insertable cardiac monitors, implantable cardiomonitors, pal-pitations, stroke, syncope, atrial fibrillation, telemedicine
References
- Petrovičova A., Kurča E., Brozma M., Hasilla J., Va-hala P., Blaˇsko P. et al. Detection of occult paroxys-mal atrial fibrilation by implantable long-term elec-trocardiographic monitoring in cryptogenic stroke and transient ischemic attack population: a study protocol for prospective matched cohort study. BMC Cardiovasc. Disord. 2015; 15: 160. DOI:10.1186/s12872-015-0160-8
- Diederichsen S.Z., Haugan K.J., Køber L., Højberg S., Brandes A., Kronborg C. et al. Atrial fibrillation detected by continuous electrocardiographic moni-toring using implantable loop recorder to prevent stroke in individuals at risk (the LOOP study): Ratio-nale and design of a large randomized controlled tri-al. Am. Heart J. 2017; 187: 122–32. DOI:10.1016/j.ahj.2017.02.017
- Benditt D.G., Adkisson W.O., Sutton R., Mears R.K., Sakaguchi S. Ambulatory diagnostic ECG monitoring for syncope and collapse: An assessment of current clinical practice in the United States. Pacing Clin. Electrophsiol. 2018; 41 (2): 203–9. DOI:10.1111/pace.13265
- Yano Y., Greenland Ph., Donald M.L.G., Daoud E.G., Koehler J.L., Ziegler P.D. Simulation of daily snap-shot rhythm monitoring to identify atrial fibrillation in continuously monitored patients with stroke risk factors. PLoS One. 2016; 11 (2): e0148914. DOI:10.1371/journal.pone.0148914
- Brignole M. Diagnosis and treatment of syn-cope. Heart. 2007; 93 (1): 130–6. DOI:10.1136/hrt.2005.080713
- McDaniel D., D’Orazio D. Remote management of cardiac patients: The forefront of a new standard. Modern Healthcare; 2011. Available at: https://pdf. medicalexpo.com/pdf/st-jude-medical/remote-management-cardiac/70886-149623.html (22 April 2020)
- Arzbaecher R., Hampton D., Burke M.C., Garrett M.C. Sub- cutaneous ECG monitors and their field of view. J. Electrocar- diol. 2010; 43 (6): 601–5
- Ooi S.-Y., Ng B., Singarayar S., Illes P., Mohamed U., Razak S. et al. BioMonitor 2 Pilot Study: Early experi-Implantable Cardiac Monitor. Heart Lung Circ. 2018; 27 (12): 1462–6. DOI:10.1016/j.hlc.2017.09.005
- Tomson T., Passman R. The Reveal LINQ insertable cardiac monitor. Expert Rev. Med. Devices. 2015; 12 (1): 7–18. DOI:10.1586/17434440.2014.953059
- Safe Alternative to Conventional Follow Up is Re-mote ICD Monitoring: Available at: http://www.medi-calnewstoday.com/ releases/233582.php (22 April 2020)
- Tajstra M., Sokal A., Gwóźdź A., Wilczek M., Gacek A., Wojciechowski K. et al. Remote Supervision to decrease hospitalization rate. Unified and integrated platform for data collected from devices manufac-tured by different companies: Design and rationale of the RESULT study. Ann. Noninvasive Electrocardiol. 2017; 22 (4): e12418. DOI:10.1111/anec.12418
- Mittal S., Sanders P., Pokushalov E., Dekker L., Kere-iakes D., Schloss E.J. et al. Safety profile of a min-iaturized insertable cardiac monitor: results from two prospective trials. Pacing Clin. Electrophysiol. 2015; 38 (12): 1464–9. DOI:10.1111/pace.12752
- Diederichsen S.Z., Haugan K.J., Højberg S., Holst A.G., Køber L., Pedersen K.B. et al. Complica-tions after implantation of a new-generation insert-able cardiac monitor: Results from the LOOP study. Int. J. Cardiol. 2017; 241: 229–34. DOI:10.1016/j.ijcard.2017.03.144
- Rogers G.D., Sanders P., Piorkowski C., Sohail M.R., Anand R., Crossen K. et al. In-office insertion of a miniaturized insertable cardiac monitor: Results from the Reveal LINQ In- Office 2 randomized study. Heart Rhythm. 2017; 14 (2): 218–24. DOI:10.1016/j.hrthm.2016.11.001
- Lin Y.C., Benditt D.G., Shen W.K. Management of syncope in adults: An update. Mayo Clinic. Proceed-ings. 2008; 83 (11): 1280–93
- Tarakji K.G., Mittal S., Kennergren C., Corey R., Poole J., Stromberg K. et al. Worldwide Randomized Antibiotic Envelope Infection Prevention Trial (WRAP-IT). Am. Heart J. 2016; 180: 12–21. DOI:10.1016/j.ahj.2016.06.010
- Katz J.M., Eng M.S., Carrazco C., Patel A.V., Jadon-ath R., Gribko M., Arora R., Libman R.B. Occult par-oxysmal atrial fibrillation in non-cryptogenic ischemic stroke. J. Neurol. 2018; 265 (10): 2237–42. DOI:10.1007/s00415-018-8982-9
- Passman R., Leong-Sit P., Andrei A.C., Huskin A., Tomson T.T., Bernstein R. et al. Targeted antico-agulation for atrial fibrillation guided by continuous rhythm assessment with an insertable cardiac moni-tor: The Rhythm Evaluation for Anticoagulation with Continuous Monitoring (REACT.COM) Pilot Study. J. Cardiovasc. Electrophysiol. 2016; 27 (3): 264–70. DOI:10.1111/jce.12864
- Bettin M., Dechering D., Kochhäuser S., Bode N., Eckardt L., Frommeyer G., Reinke F. Extended ECG monitoring with an implantable loop recorder in pa-tients with cryptogenic stroke: time schedule, rea-sons for explantation and incidental findings (results from the TRACK-AF trial). Clin. Res. Cardiol. 2019; 108 (3): 309–14. DOI:10.1007/s00392-018-1358-4
- Holmes D.R.J., Krucoff M.W., Mullin C., Mikdadi G., Pres- ser D., Wohns D. et al. Implanted moni-tor alerting to reduce treatment delay in patients with acute coronary syndrome events. J. Am. Coll. Cardiol. 2019; 74 (16): 2047–55. DOI:10.1016/j.jacc.2019.07.084
- Miracapillo G., Addonisio L., Breschi M., Sensi F.D.E., Manfredini E., Corbucci G. et al. Left axillary implantation of loop recorder versus the traditional left chest area: A prospective randomized study. Pac-ing Clin. Electrophysiol. 2016; 39 (8): 830–6. DOI:10.1111/pace.12875
- Hickey K.T., Hauser N.R., Valente L.E., Riga T.C., Frulla A.P., Creber R.M. et al. A single-center ran-domized, controlled trial investigating the efficacy of a mHealth ECG technology inter- vention to improve the detection of atrial fibrillation: the iHEART study protocol. BMC Cardiovasc. Disord. 2016; 16: 152. DOI:10.1186/s12872-016-0327-y
- Bhavnani S.P., Sola S., Adams D., Venkateshvaran A., Dash P.K., Sengupta P.P., ASEF-VALUES Inves-tigators. A randomized trial of pocket-echocardiog-raphy integrated mobile health device assessments in modern structural heart disease clinics. JACC Cardiovasc. Imaging. 2018; 11 (4): 546–57. DOI:10.1016/j.jcmg.2017.06.019HEARTRATECONTROLUSINGIMPLANTABLEDEVICES.WHATWEHAVEACHIEVEDANDWHATELSEISWAITINGINMODERNARHYTHMOLOGY?REVIEW