Implantable Monitors – Recent Developments

Abstract

For many years implantable cardiac monitors have proved to be helpful diagnostic tools for illuminating mechanisms of syncopes and documenting symptomatic arrhythmias in selected patients. With an increasing number of patients being treated interventionally for atrial fibrillation (AF), continuous rhythm monitoring with implantable devices can help to address several unsolved questions in this field, such as the true AF burden after an ablation procedure, the percentage of completely asymptomatic recidives and the long-term efficacy of catheter ablation, and can thereby influence the timing for discontinuation of antiarrhythmic drug treatment or even oral anticoagulation. The recently published Reveal® XT Performance Trial (XPECT) quantified the performance of the first implantable cardiac monitor with dedicated AF detection capabilities. In this validation study the AF detection algorithm was proved to deliver reliable detection of the presence or absence of AF. In addition, the AF burden could be reliably assessed and quantified. In the future, continuous monitoring strategies may be helpful to overcome the shortcomings of non-continuous monitoring and may be able to better document AF recurrence, identify the type of recurrence and document the burden of AF.