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Quartieri F, Harish M, Calò L, Ebrahim I, Fusco A, Mester S, Cauti F, Park SJ, Francia P, Giovagnoni M, Adragao P, Vezi B, Lin W, Hutson CS, Grammatico A. New insertable cardiac monitors show high diagnostic yield and good safety profile in real-world clinical practice: results from the international prospective observational SMART Registry. Europace 2023; 25:euad068. [PMID: 36935638 PMCID: PMC10227665 DOI: 10.1093/europace/euad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/05/2023] [Indexed: 03/21/2023] Open
Abstract
AIMS Insertable cardiac monitors (ICMs) are indicated for long-term monitoring of unexplained syncope or palpitations, and for detection of bradycardia, ventricular tachycardia, and/or atrial fibrillation (AF). The aim of our study was to evaluate the safety and clinical value associated with a new generation ICM (Confirm Rx™, Abbott, Illinois, USA), featuring a new remote monitoring system based on smartphone patient applications. METHODS AND RESULTS The SMART Registry is an international prospective observational study. The main endpoints were ICM safety (incidence of serious adverse device and procedure-related events (SADEs) at 1 month), ICM clinical value (incidence of device-detected true arrhythmias and of clinical diagnoses and interventions), and patient-reported experience measurements (PREMs). A total of 1400 subjects were enrolled. ICM indications included syncope (49.1%), AF (18.8%), unexplained palpitations (13.6%), risk of ventricular arrhythmia (6.6%), and cryptogenic stroke (6.0%). Freedom from SADEs at 1 month was 99.4% (95% Confidence Interval: 98.8-99.7%). In the 6-month monitoring period, the ICM detected true cardiac arrhythmias in 45.7% of patients and led to clinical interventions in a relevant proportion of patients; in particular, a pacemaker implant was performed after bradycardia detection in 8.9% of subjects who received an ICM for syncope and oral anticoagulation therapy was indicated after AF detection in 15.7% of subjects with cryptogenic stroke. PREMs showed that 78.2% of subjects were satisfied with the remote monitoring patient app. CONCLUSION The evaluated ICM is associated with an excellent safety profile and high diagnostic yield. Patients reported positive experiences associated with the use of their smartphone for the device remote monitoring.
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Affiliation(s)
- Fabio Quartieri
- Arcispedale Santa Maria Nuova, Viale Risorgimento, 80, 42123 Reggio Emilia, Italy
| | - Manyam Harish
- Erlanger Medical Center, 975 E 3rd St, Chattanooga, TN 37403, USA
| | - Leonardo Calò
- Policlinico Casilino, Via Casilina, 1049, 00169 Roma, Italy
| | - Iftikhar Ebrahim
- Netcare Unitas Hospital, 866 Clifton Ave, Die Hoewes, Centurion, 0163, South Africa
| | - Antonio Fusco
- Casa di Cura Pederzoli, Via Monte Baldo 24, 37019 Peschiera del Garda, VeronaItaly
| | - Stephen Mester
- Bay Area Cardiology Associates, 635 Eichenfeld Dr, Brandon, FL 33511, USA
| | - Filippo Cauti
- Ospedale S. Giovanni Calibita Fatebenefratelli, Via di Ponte Quattro Capi 39, 00186 Rome, Italy
| | - Seung-Jung Park
- Samsung Medical Center, 81 Ilwon-ro, Gangnam-gu, 06351 Seoul, South Korea
| | - Pietro Francia
- Ospedale S. Andrea, Via di Grottarossa, 1035, 00189 Rome, Italy
| | - Marco Giovagnoni
- Casa Di Cura Citta di Aprilia, Via delle Palme, 25, 04011 Aprilia, Italy
| | - Pedro Adragao
- Hospital de Santa Cruz, Av. Prof. Dr. Reinaldo dos Santos, 2790, 134 Carnaxide, Lisbon, Portugal
| | - Brian Vezi
- Busamed Gateway Private Hospital, 36-38 Aurora Dr, Umhlanga Rocks, Umhlanga 4319, South Africa
| | - Wenjiao Lin
- Abbott, 15900 Valley View Ct, Sylmar, CA 91342, USA
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Sencion-Akhtar N, Ferrick A, Iwai S. A case of an implantable cardiac monitor follow-up: Too little, too late. HeartRhythm Case Rep 2022; 8:658-659. [PMID: 36147713 PMCID: PMC9485660 DOI: 10.1016/j.hrcr.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Nyree Sencion-Akhtar
- Address reprint requests and correspondence: Dr Nyree Sencion-Akhtar, Westchester Medical Center, 100 Woods Rd, Valhalla, NY 10595.
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