Atrial fibrillation detection using a novel three-vector cardiac implantable monitor: the atrial fibrillation detect study
Atrial fibrillation detection using a novel three-vector cardiac implantable monitor: the atrial fibrillation detect study
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DOI：
10.1093/europace/euw181
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发表时间：
2017-07-01
期刊：
影响因子：
6.1
通讯作者：
Pappone, Carlo
中科院分区：
文献类型：
--
作者：
Ciconte, Giuseppe;Saviano, Massimo;Pappone, Carlo
连续心律监测对于临床环境中充分的房颤（AF）管理非常有价值。皮下无引线植入式心脏监护仪（ICM）可改善AF检测，克服当前可用外部记录系统的固有局限性，从而实现更准确的患者治疗。本研究旨在评估配备专用AF算法的新型三向量ICM器械的检测性能，入组了66例有AF发作风险的患者（86.4%为男性;平均年龄60.4 ± 9.4岁），这些患者接受了新型ICM植入术（BioMonitor，Biotronik SE&Co. KG，柏林，德国）。植入后4周进行体外48 h心电图霍尔特检查。将自动ICM AF分类与手动霍尔特心律失常记录进行比较。在总体研究人群中，63/66（95.5%）例患者具有可分析的霍尔特数据，39/63（62%）例患者显示至少1次真实房颤发作。所有这些患者均在ICM中存储了至少一次AF发作。在霍尔特监测中，24/63例（38%）患者未显示AF发作，其中16例ICM诊断AF的敏感性和阳性预测值分别为95.4%和76.3%。产生AF发作的准确和可靠的检测。ICM是一种有前途的工具，可用于定制个体房颤患者管理。需要进一步的长期前瞻性研究来证实这些令人鼓舞的结果。
Continuous rhythm monitoring is valuable for adequate atrial fibrillation (AF) management in the clinical setting. Subcutaneous leadless implantable cardiac monitors (ICMs) yield an improved AF detection, overcoming the intrinsic limitations of the currently available external recording systems, thus resulting in a more accurate patient treatment. The study purpose was to assess the detection performance of a novel three-vector ICM device equipped with a dedicated AF algorithm.Sixty-six patients (86.4% males; mean age 60.4 +/- 9.4 years) at risk to present AF episodes, having undergone the novel ICM implant (BioMonitor, Biotronik SE&Co. KG, Berlin, Germany), were enrolled. External 48-h ECG Holter was performed 4 weeks after the device implantation. The automatic ICM AF classification was compared with the manual Holter arrhythmia recordings. Of the overall study population, 63/66 (95.5%) had analysable Holter data, 39/63 (62%) showed at least one true AF episode. All these patients had at least one AF episode stored in the ICM. On Holter monitoring, 24/63 (38%) patients did not show AF episodes, in 16 of them (16/24, 67%), the ICM confirmed the absence of AF. The AF detection sensitivity and positive predictive value for episodes' analysis were 95.4 and 76.3%, respectively.Continuous monitoring using this novel device, equipped with a dedicated detection algorithm, yields an accurate and reliable detection of AF episodes. The ICM is a promising tool for tailoring individual AF patient management. Further long-term prospective studies are necessary to confirm these encouraging results.