Investigation of optimal position for implantable loop recorders by potential mapping with Reveal DX

Abstract

Background: Electrode positioning is important for the operation of implantable loop recorders (ILRs). This study aimed to investigate optimal electrode positions for the implantation of ILRs. Methods: Fifteen male subjects participated in the study and R wave amplitude data were collected from 15 areas in the left anterior chest area, with 4 variations of electrode angles and body positions. Results: The estimated minimum R wave amplitude values were greater than 0.3 mV (manufacturer-recommended value) when electrodes were angled vertically and positioned on the midclavicular line of the third and the forth intercostal spaces or on the left sternal border of the fourth and fifth intercostal space and when angled at 45° to the right on the left sternal border of the third and the forth intercostal space. Conclusions: Exploring areas around the left sternal border of the fourth intercostal space – where the R wave amplitudes are least affected by body positions – is a reliable method for choosing implantation locations for ILRs.

Keywords

• Implantable loop recorder
• Cardiac syncope
• R wave amplitude
• Diagnosis
• Undersensing