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Mariani JA, Weerasooriya R, van den Brink O, Mohamed U, Gould PA, Pathak RK, Lin T, Conradie A, Illes P, Pavia S, Rajamani K, Lovibond S, Matthews I, DiFiore D, Arumugam D, Schrader J, Lau DH. Miniaturized implantable cardiac monitor with a long sensing vector (BIOMONITOR III): Insertion procedure assessment, sensing performance, and home monitoring transmission success. J Electrocardiol 2020; 60:118-125. [PMID: 32361086 DOI: 10.1016/j.jelectrocard.2020.04.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/26/2020] [Accepted: 04/07/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Implantable Cardiac Monitors (ICMs) are used for long-term monitoring of arrhythmias. BIOMONITOR III is a novel ICM with a miniaturized profile, long sensing vector due to a flexible antenna, simplified implantation with a dedicated insertion tool for pocket formation and ICM placement in a single step, and daily automatic Home Monitoring (HM) function. METHODS In 47 patients undergoing BIOMONITOR III insertion for any ICM indication, 16 investigators at 10 Australian sites assessed handling characteristics of the insertion tool, R-wave amplitudes, noise burden, P-wave visibility, and HM transmission success. Patients were followed for 1 month. RESULTS All 47 attempted insertions were successful. Median time from skin incision to removal of the insertion tool after ICM insertion was 39 s (IQR 19-65) and to wound closure and cleaning was 4.7 min (IQR 3.5-7.8). All aspects of the insertion tool were rated as "good" or "excellent" in ≥97.9% and "fair" in ≤2.1% of patients, except for "force needed for tunnelling" (91.5% good/excellent, 8.5% fair). Based on HM data, R-waves in the first month were stable at 0.70 ± 0.37 mV. Median noise burden (disabling automatic rhythm evaluation) was 0.19% (IQR 0.00-0.93), equivalent to 2.7 min (IQR 0.0-13.4) per day. In HM-transmitted ECG strips with regular sinus rhythm, P-waves were visible in 89 ± 24% of heart cycles. Patient-individual automatic Home Monitoring transmission success was 98.0% ± 5.5%. CONCLUSIONS The novel ICM performed well in all aspects studied, including fast insertion, reliable R-wave sensing, good P-wave visibility, and highly successful HM transmissions.
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Affiliation(s)
- Justin A Mariani
- The Alfred Hospital, 55 Commercial Rd, Melbourne, VIC 3004, Australia; Central Clinical School, Monash University, 99 Commercial Rd, Melbourne, VIC 3004, Australia.
| | - Rukshen Weerasooriya
- University of Western Australia, Department of Medicine, Crawley, WA 6000, Australia.
| | - Olivier van den Brink
- The Alfred Hospital, 55 Commercial Rd, Melbourne, VIC 3004, Australia; Central Clinical School, Monash University, 99 Commercial Rd, Melbourne, VIC 3004, Australia.
| | - Uwais Mohamed
- St Vincent's Hospital, 41 Victoria Parade, Fitzroy, VIC 3065, Australia.
| | - Paul A Gould
- The University of Queensland, and Department of Cardiology, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia.
| | - Rajeev K Pathak
- Australian National University and The Canberra Hospital, Yamba Dr, Canberra, ACT 2605, Australia.
| | - Tina Lin
- GenesisCare Victoria, 5/126 Wellington Pde, East Melbourne, VIC 3002, Australia.
| | - Andre Conradie
- GenesisCare, Friendly Society Private Hospital, 19-23 Bingera Street, Bundaberg, QLD 4670, Australia.
| | - Peter Illes
- Sydney Adventist Hospital, 185 Fox Valley Road, Wahroonga, NSW 2076, Australia
| | - Stephen Pavia
- GenesisCare, The Wesley Hospital, 30 Chasely St, Auchenflower, QLD 4066, Australia.
| | - Kushwin Rajamani
- University of Western Australia, Department of Medicine, Crawley, WA 6000, Australia
| | - Sam Lovibond
- The Alfred Hospital, 55 Commercial Rd, Melbourne, VIC 3004, Australia; Central Clinical School, Monash University, 99 Commercial Rd, Melbourne, VIC 3004, Australia
| | - Ian Matthews
- St Vincent's Hospital, 41 Victoria Parade, Fitzroy, VIC 3065, Australia.
| | - David DiFiore
- GenesisCare, Friendly Society Private Hospital, 19-23 Bingera Street, Bundaberg, QLD 4670, Australia.
| | - Deepak Arumugam
- GenesisCare, The Wesley Hospital, 30 Chasely St, Auchenflower, QLD 4066, Australia.
| | - Jürgen Schrader
- Biotronik SE & Co. KG, Woermannkehre 1, 12359 Berlin, Germany.
| | - Dennis H Lau
- Centre for Heart Rhythm Disorders, The University of Adelaide and Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia.
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Ciconte G, Giacopelli D, Pappone C. The Role of Implantable Cardiac Monitors in Atrial Fibrillation Management. J Atr Fibrillation 2017; 10:1590. [PMID: 29250232 DOI: 10.4022/jafib.1590] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/19/2017] [Accepted: 08/26/2017] [Indexed: 11/10/2022]
Abstract
Continuous heart rhythm monitoring using implantable cardiac monitors (ICMs) for atrial fibrillation (AF) management is steadily increasing in current clinical practice, even in the absence of an established indication provided by international guidelines. The increasing use of such devices is mainly associated with recent technological improvements including miniaturization, easier implant procedures, and remote monitoring, all of which make this strategy continuously more appealing and promising. For these and other reasons, ICMs have been proven to be a safe and highly effective tool for detecting AF episodes. However, ICMs are not the best option for every patient, as limitations exist. Therefore, it is imperative to weigh the possible benefits against the potential limitations of using these devices when deciding individualized patient care.
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Affiliation(s)
- Giuseppe Ciconte
- Department of Arrhythmology, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese (MI), Italy
| | | | - Carlo Pappone
- Department of Arrhythmology, IRCCS Policlinico San Donato, University of Milan, San Donato Milanese (MI), Italy
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