Effectiveness of remote monitoring in the management of syncope and palpitations
Open accessAbstract
AIMS: Recently, the remote transmission of data detected by implantable loop recorders (ILRs) has become available. The aim of this study was to evaluate effectiveness and acceptance of remote monitoring in the clinical management of syncope and palpitations in patients with ILR. METHODS AND RESULTS: Consecutive patients implanted with ILR (Reveal DX/XT Medtronic, Inc.) and followed up by means of remote monitoring (CareLink(®)) were included. The patients were requested to transmit the data stored in the ILR every week, via the CareLink system, or more frequently during the first period. Patient acceptance of ILR was evaluated by means of a questionnaire concerning physical and mental components. Forty-seven patients (27 males, average age 64 ± 19 years) were enrolled and followed up for 20 ± 13 weeks. Thirty-two patients (68%) had at least one ECG recording of a true relevant event. The mean time from ILR implantation to the first true relevant ECG was 28 ± 49 days, which was 71 ± 17 days less than in the clinical practice of 3-monthly in-office follow-up examinations. Thirty-eight patients (81%) had at least one false arrhythmic event, mainly false asystole and false fast ventricular tachycardia. In the absence of Carelink transmission, at least one episode of memory saturation of ILR would have occurred in 21 patients (45%) that would have limited the diagnostic yield. Patient compliance was good even though one-fifth had some minor psychological concern regarding the ILR implant. CareLink was well accepted and judged easy to use. CONCLUSION: Remote monitoring enhances the diagnostic effectiveness of Reveal, limiting the risk of memory saturation due to the high number of false detections and reducing the time to diagnosis. Both ILR and CareLink were well accepted and well tolerated by the patients, as they were considered useful.
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Some recent studies have shown that implementing remote monitoring increases the diagnostic yield and achieves diagnosis earlier than without remote monitoring.
“Some recent studies have shown that implementing remote monitoring increases the diagnostic yield and achieves diagnosis earlier than without remote monitoring. 169-171”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [170]
The Discussion reports that relevant ECGs were detected in 28 days, an estimated 71 days earlier than with the departments’ three-monthly in-office follow-up. It says remote monitoring *potentially* increases the diagnostic yield of implantable loop recorders by reducing memory saturation; the claim states that increase as an established result. Page numbers are unavailable in our copy. (LLM, conf=0.88)
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2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951 · see citing works
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- Authors
- Furukawa, T., Maggi, R., Bertolone, C., Ammirati, F., Santini, M., Ricci, R., Giada, F., & Brignole, M.
- Affiliations
- Presidio Ospedaliero (IT)
- Ospedale San Filippo Neri (IT)
- Ospedale dell' Angelo (IT)
- Corresponding author
- Brignole, M.
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-01-17
- Volume
- 13
- Issue
- 3
- Pages
- 431-437
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2133404031
- Cited by
- 57
- References
- 22
- Citations by year
- 2026: 4 · 2024: 1 · 2023: 3 · 2022: 3 · 2019: 2 · 2018: 9 · 2017: 4 · 2016: 3 · 2015: 5 · 2014: 4 · 2013: 13 · 2012: 4
- FWCI
- 7.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
- Keywords
- remote monitoring, implantable loop recorder, syncope, palpitations, memory saturation, patient acceptance, diagnostic yield, arrhythmia detection
- MeSH terms
- Adult, Aged, Aged, 80 and over, Arrhythmias, Cardiac, Electrocardiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Monitoring, Physiologic, Patient Compliance, Prospective Studies, Retrospective Studies, Syncope, Electrocardiography, Ambulatory, Prostheses and Implants, Remote Sensing Technology
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