Diagnostic yield of an insertable cardiac monitor in a large patient population

Dennis H. Lau, MBBS, PhD, FHRS; Bertrand Pierre, MD; Pilar Cabanas, MD; Eimo Martens, MD; Giovanni Bisignani, MD; Daniel Hofer, MD; Antonio Berruezo, MD; Romain Eschalier, MD, PhD; Jacques Mansourati, MD; Thomas Gaspar, MD; Victor Manuel Sanfins, MD; Andrejs Erglis; Andreas Hain, MD; Georgios Papaioannou, MD; Alessandro Cuneo, MD; Verena Tscholl, MD; Jürgen Schrader, PhD; Thomas Deneke, MD

Heart Rhythm O2 (Feb 2023)

Diagnostic yield of an insertable cardiac monitor in a large patient population

Dennis H. Lau, MBBS, PhD, FHRS,
Bertrand Pierre, MD,
Pilar Cabanas, MD,
Eimo Martens, MD,
Giovanni Bisignani, MD,
Daniel Hofer, MD,
Antonio Berruezo, MD,
Romain Eschalier, MD, PhD,
Jacques Mansourati, MD,
Thomas Gaspar, MD,
Victor Manuel Sanfins, MD,
Andrejs Erglis,
Andreas Hain, MD,
Georgios Papaioannou, MD,
Alessandro Cuneo, MD,
Verena Tscholl, MD,
Jürgen Schrader, PhD,
Thomas Deneke, MD

Affiliations

Dennis H. Lau, MBBS, PhD, FHRS: Department of Cardiology, Royal Adelaide Hospital and the University of Adelaide, Adelaide, Australia; Address reprint requests and correspondence: Dr Dennis H. Lau, Department of Cardiology, Royal Adelaide Hospital, 1 Port Road, Adelaide, SA 5000, Australia.
Bertrand Pierre, MD: Department of Cardiology, Tours University Hospital, Chambray-lès-Tours, France
Pilar Cabanas, MD: Department of Cardiology, Hospital Álvaro Cunqueiro, Vigo, Spain
Eimo Martens, MD: Klinikum rechts der Isar, Technical University Munich, Munich, Germany
Giovanni Bisignani, MD: Department of Cardiology, Ospedale Civile Ferrari, Castrovillari, Italy
Daniel Hofer, MD: Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
Antonio Berruezo, MD: Department of Cardiology, Teknon Heart Institute, Barcelona, Spain
Romain Eschalier, MD, PhD: Department of Cardiology, Hôpital Gabriel Montpied, Clermont-Ferrand, France
Jacques Mansourati, MD: Department of Cardiology, University Hospital of Brest, Brest, France
Thomas Gaspar, MD: Heart Center, University of Dresden, Dresden, Germany
Victor Manuel Sanfins, MD: Department of Cardiology, Hospital Senhora da Oliveira – Guimarães, Guimarães, Portugal
Andrejs Erglis: Department of Cardiology, Pauls Stradins Clinical University Hospital, Riga, Latvia
Andreas Hain, MD: Department of Cardiology, Kerckhoff-Klinik GmbH, Bad Nauheim, Germany
Georgios Papaioannou, MD: Department of Cardiology, Hôpital Saint-André, Bordeaux, France
Alessandro Cuneo, MD: Department of Cardiology, Krankenhaus Maria-Hilf Stadtlohn, Stadtlohn, Germany
Verena Tscholl, MD: Department of Cardiology, Charité Universitaetsmedizin, Campus Mitte, Berlin, Germany
Jürgen Schrader, PhD: Department of Cardiology, Biotronik SE & Co.KG, Berlin, Germany
Thomas Deneke, MD: Department of Cardiology, Rhön Clinic Campus Bad Neustadt, Saale, Germany

Journal volume & issue: Vol. 4, no. 2
pp. 97 – 102

Abstract

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Background: Insertable cardiac monitors (ICMs) are increasingly used for cardiac rhythm diagnosis with expanding indications. Little has been reported about their use and efficacy. Objective: The study sought to evaluate the clinical utility of a novel ICM (Biotronik BIOMONITOR III) including the time to diagnosis in unselected patients with different ICM indications. Methods: Patients from 2 prospective clinical studies were included to determine the diagnostic yield of the ICM. The primary endpoint was time to clinical diagnosis per implant indication or to the first change in atrial fibrillation (AF) therapy. Results: A total of 632 patients were included with a mean follow-up of 233 ± 168 days. Of 384 patients with (pre)syncope, 34.2% had a diagnosis at 1 year. The most frequent therapy was permanent pacemaker implantation. Of 133 patients with cryptogenic stroke, 16.6% had an AF diagnosis at 1 year, resulting in oral anticoagulation. Of 49 patients with an indication for AF monitoring, 41.0% had a relevant change in AF therapy based on ICM data at 1 year. Of 66 patients with other indications, 35.4% received a rhythm diagnosis at 1 year. Moreover, 6.5% of the cohort had additional diagnoses: 26 of 384 patients with syncope, 8 of 133 patients with cryptogenic stroke, and 7 of 49 patients with AF monitoring. Conclusion: In a large unselected patient population with heterogeneous ICM indications, the primary endpoint of rhythm diagnosis was achieved in ∼1 in 4, and additional clinically relevant findings was achieved in 6.5% of patients at short-term follow-up.

Published in Heart Rhythm O2

ISSN: 2666-5018 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/heart-rhythm-o2

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