Clinicians at Waikato Hospital are the first experts in New Zealand to implant the world’s smallest cardiac monitor, which is capable of wirelessly diagnosing potentially dangerous irregular heartbeats.
The first recipient will be a 43-year-old Taranaki woman who has been extremely fit, so much so that she ran a marathon earlier this year. But she has a history of palpitations every six weeks which are short lasting events with associated dizziness.
Experienced cardiologist Dr Clyde Wade will use the miniature Medtronic Reveal LINQ™ Implantable Cardiac Monitor for two procedures tomorrow (Monday 9 June) at one of Waikato Hospital’s new catheterisation laboratories (Cath Lab).
Dr Wade says it will help clinicians in their efforts to help prevent the high number of arrhythmia-related events, including cases of death in New Zealand, through detection and appropriate treatment of heart rhythm disorders.
Without appropriate diagnosis and treatment, the effects of undetected or misdiagnosed heart rhythm disorders can be fatal and occur without warning.
Clinicians will use the new insertable cardiac monitor to detect minute changes in a patient’s heart rhythm by continuously monitoring, recording and storing data inside the device for up to three years.
In addition, due to its wireless monitoring capabilities, physicians can get notifications quickly if patients need medical attention between regular appointments.
A lack of awareness of heart rhythm disorders in the medical community means they often go unrecognised or are misdiagnosed. According to group Arrhythmia Alliance, one such disorder, known as syncope (or fainting), can be caused by an underlying cardiac condition yet is often misdiagnosed as epilepsy meaning people receive medication to treat epilepsy rather than their heart condition.
Alternately, atrial fibrillation (AF), the most common heart rhythm disorder, which may result in stroke, is often intermittent. This can make it difficult for a clinician to confirm a diagnosis.
Through appropriate use of ICM technology, there is an opportunity to prevent a high number of arrhythmia-related deaths in New Zealand.
What this means to patients:
Undetected, heart rhythm disease can be lethal and occur without warning. Detecting underlying heart rhythm conditions is the first step to improving health outcomes. As symptoms can be infrequent and unexpected, the effectiveness of short-term investigative tools such as 24 hour holter monitors or time-consuming hospital surveillance visits are limited.
Placed just beneath the skin’s surface through a small incision of less than 1 cm, the LINQ ICM provides uninterrupted monitoring for up to three years, plus is nearly invisible to the naked eye in most patients. The miniaturisation of the LINQ ICM provides smaller patients including children access to the technology with little cosmetic impact.
The number of New Zealanders living with heart rhythm disease is currently unknown, with high numbers of the population undiagnosed. For example, while more than 88,104 Kiwis are diagnosed with AF, a further 20,000 Kiwis are estimated to be living with the condition and undiagnosed. Stroke is one of the most serious consequences of AF and imposes substantial personal and economic costs. Ineffective or no stroke prevention treatment leads to even more strokes, poor outcomes for patients and is costly to the New Zealand health system.
Through use of ICM, these diseases may be detected to prompt appropriate clinical management. Technology including pacemaker therapy and implantable cardioverter defibrillator (ICD) therapy is available to treat the condition once detected.
Adding a level of complexity for patients with underlying heart rhythm disease, their symptoms (‘fluttering’ heartbeat, an irregular pulse, weakness, dizziness, fainting and/or seizures) can appear similar to other diseases such as epilepsy. This highlights the challenge clinician’s face in appropriately diagnosing and treating heart rhythm disease, opposed to other heart or neurological conditions.
The LINQ ICM is MR-Conditional, allowing patients to have both continuous heart monitoring and Magnetic Resonance Imaging (MRIs) if needed. This is important as MRI is used to diagnose and manage a wide range of conditions, including some cancers, as well as many neurological and musculoskeletal conditions, as well as some cardiovascular disorders. According to estimates, 50-75 per cent of patients worldwide with implanted cardiac devices are expected to need an MRI scan during the lifetime of their devices. In addition, due to its continuous and wireless monitoring capabilities, physicians can be notified quickly if patients need medical attention between regular appointments.
About the technology:
The Medtronic Reveal ICM is a new miniaturised insertable heart monitor designed to help physicians quickly and accurately diagnose irregular, and potentially lethal, heartbeats. As the world’s smallest ICM (about one third of the size of an AAA battery), the LINQ ICM has the same battery life, and more data memory, than other heart monitors.
The LINQ ICM battery is powerful enough to continuously and wirelessly monitor a patient’s heart for up to three years, and sends information to a patient’s physician to help them make an accurate diagnosis and determine a treatment plan.
About heart rhythm disease:
When the heart’s electrical system malfunctions, the normal rhythm of the heart can be affected. Depending on the abnormality, the heart can beat too fast, too slow, irregularly, or not all. Heart rhythm disturbances may occur because of problems within the heart itself or be the result of abnormalities in the body’s environment that can affect the heart’s ability to conduct electricity. Heart rhythm disorders can appear symptom free; however the effects can have a significant impact on a person’s quality of life and can be fatal.
Atrial Fibrillation is an abnormality in the rhythm of the heart. It involves the upper chambers of the heart, beating irregularly. As the atria control the normal rhythm of the heart this means that your pulse becomes irregular. AF is the most common form of arrhythmia, affecting four out of every 100 people over the age of 65. AF can increase the risk of stroke.
Syncope, commonly known as fainting, can also be cardiogenic and are more likely to produce serious morbidity or mortality and require prompt or even immediate treatment.
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