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Objective:The underlying causes of unexplained syncope and palpitations are difficult to determine in clinical practice. This study was designed to investigate the value of the insertable cardiac monitor (ICM) for the diagnosis of the unexplained syncope and palpitations.Methods:A total of 184 patients with syncope or palpitations due to unexplained reasons were enrolled in the First Affiliated Hospital of Xinjiang Medical University (144 patients with unexplained syncope and 40 patients with unexplained palpitations) from October 2015 to October 2019. Among them, 99 patients (77 patients with unexplained syncope and 22 patients with unexplained palpitations) were received ICM implantation (the ICM implanted group) and 85 patients (67 patients with unexplained syncope and 18 patients with unexplained palpitations) were not (the non-ICM implanted group). The patients in the ICM implanted group were followed up once every 3 months until the occurrence of syncope or palpitations. During follow-up, the electrocardiograph (ECG) data recorded by ICM were collected and analyzed retrospectively. The patients in the non-ICM implanted group underwent routine follow-up.Results:The follow-up time of the ICM implanted group was (29.3±9.3) months, and the follow-up time of the non-ICM implanted group was (27.2±10.4) months. The total detection rate (syncope and palpitations) in the implanted ICM group was much higher than that in the non-ICM implanted group (38.4% vs. 3.5%, P<0.001), with syncope detection rate of 40.3% in the implanted ICM group and 3.0% in the non-ICM implanted group ( P<0.001), and palpitation detection rate of 31.8% in the implanted ICM group and 5.6% in the non-ICM implanted group ( P<0.05). Conclusions:Application of ICM greatly improved the diagnosis rate of patients with unexplained syncope and palpitations. It is recommended for patients with unexplained syncope and palpitations to implant ICM as soon as possible.
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Objective@#To investigate the accuracy of arrhythmia detection algorithm and the effectiveness of Reveal LINQ insertable cardiac monitor (ICM).@*Methods@#This single-center, descriptive, non-controlled clinical study was designed to enroll consecutive patients who were implanted with Reveal LINQ ICM in Minneapolis Veterans Affairs Medical Center from June 19, 2014 to April 18, 2017. The safety of implant procedure, the accuracy of automatic arrhythmia detection algorithm and the clinical effectiveness were evaluated and validated independently by two physicians.@*Results@#Sixty patients with average age of (65±13) years (30-89 years) were enrolled and the follow-up duration was 466 days (30-1 072 days). Of these, 57 patients are male. The indications of ICM implantation were unexplained syncope in 35 cases, cryptogenic stroke in 13 cases, atrial fibrillation (AF) management in 5 cases, and palpitations in 7 cases. The implantation procedure was safe and successful in all patients without complications. The detection accuracy of arrhythmia algorithm was 86% (620/723), 82% (2 369/2 876), and 30% (411/1 380) for tachycardia, bradycardia, and pause events, respectively. The detection accuracy of arrhythmia algorithm for AF was 17% (5/30), 60% (1 569/2 632) and 69% (172/251) for cryptogenic stroke, unexplained syncope, and AF management, respectively. Important clinical findings were observed in 15% (9/60) patients. Only 5% (3/60) patients had important findings based on the intended clinical indications.@*Conclusion@#The Reveal LINQ ICM is a safe, simple, and effective procedure for the detection of tachycardia and bradycardia events. However, the automatic AF and pause events detection algorithm had high false positive rate which requires further improvement.