Key result
Insertable cardiac monitors have expanded indications including inherited cardiomyopathies and cryptogenic stroke, with newer devices offering smaller sizes and remote monitoring capabilities.
Why the study?
Indications for insertable cardiac monitors have recently expanded beyond recurrent unexplained syncope, warranting an overview of current indications and latest devices.
This review summarizes the expanded clinical indications for insertable cardiac monitors and compares the features of contemporary commercially available devices.
INTRODUCTION: Recurrent unexplained syncope is a well-established indication for an insertable cardiac monitor (ICM). Recently, the indications for an ICM have been expanded. AREAS COVERED: This review article discusses the current indications for ICMs and gives an overview of the latest generation of commercially available ICMs. EXPERT COMMENTARY: The 2018 ESC Syncope guidelines have expanded the indications for an ICM to patients with inherited cardiomyopathy, inherited channelopathy, suspected unproven epilepsy, and unexplained falls. ICMs are also increasingly used for the detection of subclinical atrial fibrillation (AF) in patients with cryptogenic stroke. Whether treatment of subclinical AF (SCAF) with oral anticoagulation prevents recurrent stroke is yet unknown. The current generation of ICMs are smaller, easier to implant, have better diagnostics, and are capable of remote monitoring. The Reveal LINQ (Medtronic) is the smallest ICM and has the most extensive performance and clinical data. The BioMonitor 2 (Biotronik) is the largest ICM but has excellent R-wave amplitudes, longest longevity, and reliable remote monitoring. The Confirm Rx (Abbott) is capable to provide mobile data transmission enabled by a smartphone app. Future generation of ICMs will incorporate heart failures indices to facilitate remote monitoring of heart failure patients.
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Sakhi et al. (2018) conducted a review in Recurrent unexplained syncope, inherited cardiomyopathy, inherited channelopathy, suspected unproven epilepsy, unexplained falls, cryptogenic stroke. Insertable cardiac monitors (ICMs) was evaluated. Insertable cardiac monitors have expanded indications including inherited cardiomyopathies and cryptogenic stroke, with newer devices offering smaller sizes and remote monitoring capabilities.
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