Article, 2015

An update on insertable cardiac monitors: examining the latest clinical evidence and technology for arrhythmia management

Future Cardiology, ISSN 1744-8298, 1479-6678, Volume 11, 3, Pages 333-346, 10.2217/fca.15.15

Contributors

Olsen, Flemming Javier 0000-0001-9511-8375 [1] Biering-Srensen, Tor [1] [2] [3] Krieger, Derk Wolfgang (Corresponding author) [3] [4]

Affiliations

  1. [1] Department of Cardiology, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
    2. [NORA names: Capital Region of Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD];
  2. [2] Harvard University
    3. [NORA names: United States; America, North; OECD];
  3. [3] University of Copenhagen
    4. [NORA names: KU University of Copenhagen; University; Denmark; Europe, EU; Nordic; OECD];
  4. [4] Rigshospitalet
    5. [NORA names: Capital Region of Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD]

Abstract

Continuous cardiac rhythm monitoring has undergone compelling progress over the past decades. Cardiac monitoring has emerged from 12-lead electrocardiograms being performed at the discretion of the treating physician to in-hospital telemetry, Holter monitoring, prolonged external event monitoring and most recently toward insertable device monitoring for several years. Significant advantages and disadvantages pertaining to these monitoring options will be addressed in this review. Insertable cardiac monitors have several advantages over external monitoring techniques and may signify a clinical turning point in the field of arrhythmia management. However, their role in the detection of paroxysmal atrial fibrillation after cryptogenic strokes has yet to evolve. This will be the main focus of this review. Issues surrounding patient selection, clinical relevance and determination of cost-effectiveness for prolonged cardiac monitoring require further studies. Furthermore, insertable cardiac monitoring has not only the potential to augment diagnostic capabilities but also to improve the management of paroxysmal atrial fibrillation.

Keywords

Cardiac, Holter, Holter monitoring, advantage, arrhythmia management, arrhythmias, atrial fibrillation, capability, cardiac monitoring, cardiac rhythm monitoring, clinical evidence, clinical relevance, clinical turning point, continuous cardiac rhythm monitoring, cost-effective, cryptogenic stroke, decades, detection, detection of paroxysmal atrial fibrillation, determinants of cost-effectiveness, determination, device monitoring, diagnostic capabilities, discretization, electrocardiogram, event monitoring, evidence, fibrillation, field, field of arrhythmia management, insertable cardiac monitor, issues, management, management of paroxysmal atrial fibrillation, monitoring, monitoring options, monitoring techniques, options, paroxysmal atrial fibrillation, patient selection, patients, physicians, point, potential, progression, prolonged cardiac monitoring, relevance, review, rhythm monitoring, selection, significant advantage, stroke, study, technique, technology, telemetry, treating physician, turning point, update, years

Funders

  • Medtronic (United States)
  • Capital Region of Denmark

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