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To the best of our knowledge, this study is first to report on the use of implantable loop recorders for heart failure management.
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Continuous monitoring detected arrhythmic events that led to therapeutic changes in 13 patients. These events were not detected by routine visits to the cardiologist.
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The use of an implantable loop recorder could potentially impact patient management, but additional study is needed.
Introduction
Materials and Methods
Study design
Inclusion and exclusion criteria
Reveal XT implantation
Follow-up
Analysis
Results
Patient demographics
age (years) | 72 ± 8.8 |
men | 13 (43.3) |
weight (kg) | 78.3 ± 16 |
LVEF | 44.5 ± 7.8 |
NYHA
| |
II | 25 (83.3) |
III | 5 (16.7) |
heart failure duration
| |
<2 months | 4 (13.3) |
<3 months | 4 (13.3) |
<6 months | 2 (6.7) |
>6 months | 20 (66.7) |
medical history
| |
coronary artery disease | 11 (36.7) |
revascularisation (PCI and/or CABG) | 9 (30) |
valvular heart disease | 2 (6.7) |
diabetes mellitus | 9 (30) |
hypertension | 19 (63.3) |
peripheral artery disease | 4 (13.3) |
renal insufficiency (GFR <60 ml/min/1.73 m2) | 6 (20) |
medication
| |
beta blocker | 25 (83.3) |
ACEi/ARBs | 27 (90) |
antiplatelet therapy | 18 (60) |
calcium antagonist | 5 (16.7) |
antiarrhythmics | 1 (3.3) |
diuretics | 18 (60) |
nitrates | 4 (13.3) |
Follow-up
Detection of pre-specified events
sex | age | heart failure | event | action |
---|---|---|---|---|
female | 81 | HFREF | bradycardia/NSVT | none |
female | 68 | HFREF | asystole | dose beta blocker changed |
male | 65 | HFREF | atrial fibrillation | dose beta blocker changed/OAC started |
male | 78 | HFREF | asystole | none |
male | 86 | HFPEF | bradycardia/Atrial fibrillation | OAC started |
male | 71 | HFREF | atrial fibrillation | OAC started |
female | 77 | HFREF | SVT | dose beta blocker changed |
female | 74 | HFREF | atrial fibrillation | OAC started |
male | 59 | HFREF | atrial fibrillation | OAC started |
female | 74 | HFREF | asystole | dose beta blocker changed |
female | 65 | HFREF | atrial fibrillation | dose beta blocker changed/OAC started |
male | 62 | HFREF | atrial fibrillation | OAC started |
male | 71 | HFREF | atrial fibrillation | OAC started |
female | 71 | HFPEF | bradycardia | beta blocker stopped |
female | 80 | HFPEF | AV block | pacemaker implanted |