An implantable loop recorder or smartphone based single-lead electrocardiogram to detect arrhythmia in adults with congenital heart disease?

Autor:	Koole MA; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.; Cardiology Centers of the Netherlands, Amsterdam, Netherlands.; Department of Cardiology, Rode Kruis Ziekenhuis Beverwijk, Beverwijk, Netherlands., Kauw D; Department of Cardiology, Haga Teaching Hospital, The Hague, Netherlands., Kooiman KM; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands., de Groot JR; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands., Robbers-Visser D; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands., Tulevski II; Cardiology Centers of the Netherlands, Amsterdam, Netherlands., Mulder BJ; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands., Bouma BJ; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands., Schuuring MJ; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.; Netherlands Heart Institute, Utrecht, Netherlands.; Department of Cardiology, UMC Utrecht, Utrecht, Netherlands.
Jazyk:	angličtina
Zdroj:	Frontiers in cardiovascular medicine [Front Cardiovasc Med] 2023 Jan 06; Vol. 9, pp. 1099014. Date of Electronic Publication: 2023 Jan 06 (Print Publication: 2022).
DOI:	10.3389/fcvm.2022.1099014
Abstrakt:	Background: The European Society of Cardiology (ESC) guidelines for the management of adult congenital heart disease (ACHD) recommend screening in patients at risk for arrhythmic events. However, the optimal mode of detection is unknown. Methods: Baseline and follow-up data of symptomatic ACHD patients who received an implantable loop recorder (ILR) or who participated in a smartphone based single-lead electrocardiogram study were collected. The primary endpoint was time to first detected arrhythmia. Results: In total 116 ACHD patients (mean age 42 years, 44% male) were studied. The ILR group ( n = 23) differed from the smartphone based single-lead electrocardiogram group ( n = 93) in having a greater part of males and had more severe CHD and (near) syncope as qualifying diagnosis. In the smartphone based single-lead electrocardiogram group history of arrhythmia and palpitations were more frequent (all p < 0.05). Monitoring was performed for 40 and 79 patient-years for the ILR- and smartphone based single-lead electrocardiogram group, respectively. Arrhythmias occurred in 33 patients with an equal median time for both groups to first arrhythmia of 3 months (HR of 0.7, p = 0.81). Furthermore, atrial fibrillation occurred most often ( n = 16) and common therapy changes included medication changes ( n = 7) and implantation of pacemaker or Implantable Cardioverter Defibrillator (ICD) ( N = 4). Symptoms or mode of detection were not a determinant of the first event. Conclusion: Non-invasive smartphone based single-lead electrocardiogram monitoring could be an acceptable alternative for ILR implantation in detecting arrhythmia in symptomatic ACHD patients in respect to diagnostic yield, safety and management decisions, especially in those without syncope. Competing Interests: IT was shareholder in ventures supplying hardware and software implemented in the methods of this study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Koole, Kauw, Kooiman, de Groot, Robbers-Visser, Tulevski, Mulder, Bouma and Schuuring.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu