植入式心电事件监测仪在房颤中的应用及进展

doi:10.3969/j.issn.1006-5725.2024.21.021

Abstract

Abstract:

Atrial fibrillation （AF） is a type of supraventricular arrhythmia characterized by uncoordinated atrial activation， ineffective atrial contraction. It has a high incidence rate and is often complicated by stroke， heart failure， and myocardial disease induced by tachycardia， causing a significant burden on patients and their families. Comprehensive management of AF is crucial for effectively reducing mortality， disability， and improving prognosis. However， traditional electrocardiogram （ECG） monitoring often misses asymptomatic and paroxysmal AF at a higher possibility. In recent years， a new device for monitoring AF， insertable cardiac monitor （ICM）， has emerged to overcome the limitations of traditional arrhythmia monitoring， for it provides real-time ECG monitoring and alerts for users. ICMs have been widely used in multiple medical senarios， primarily for patients with unexplained syncope， and recently they are adopted to monitor AF However， its role in AF monitoring has not received significant attention in clinical practice.Based on relevant literature， this article reviews the application effect of ICM in monitoring AF and the latest research progress in the field and evaluates its advantages and disadvantages to provide some references for AF management.

Key words: atrial fibrillation, insertable cardic monitor, clinical application, comprehensive management, effectiveness, safety

CLC Number:

R541.75

Yimei HUANG,Lulu ZHAO,Baotong. HUA. Application effect of insertable cardiac monitorin atrial fibrillation monitoring[J]. The Journal of Practical Medicine, 2024, 40(21): 3095-3100.

References 47

1	SHI S， TANG Y， ZHAO Q， et al. Prevalence and risk of atrial fibrillation in China： A national cross-sectional epidemiological study［J］. Lancet Reg Health West Pac， 2022， 23：100439. doi:10.1016/j.lanwpc.2022.100439 doi: 10.1016/j.lanwpc.2022.100439
2	YUAN K， ZHAO P， WANG L. Molecular mechanism of atrial remodeling in patients with aging atrial fibrillation under the expression of microRNA-1 and microRNA-21［J］. Bioengineered， 2021， 12（2）：12905-12916. doi:10.1080/21655979.2021.2008668 doi: 10.1080/21655979.2021.2008668
3	JANUARY C T， WANN L S， CALKINS H， et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation： A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons［J］. Circulation， 2019， 140（2）：e125-e151. doi:10.1161/cir.0000000000000719 doi: 10.1161/cir.0000000000000719
4	AGGARWAL G， AGGARWAL S， ALLA V， et al. Subcutaneouscardiac Rhythm Monitors A Comprehensive Review［J］. JAFIB， 2021， 13（5）：2387. doi:10.4022/jafib.2387 doi: 10.4022/jafib.2387
5	ASSAF A， THEUNS D A， MICHELS M， et al. Usefulness of insertable cardiac monitors for risk stratification： current indications and clinical evidence［J］. Expert Rev Med Devices， 2023， 20（2）：85-97. doi:10.1080/17434440.2023.2171862 doi: 10.1080/17434440.2023.2171862
6	UNGAR A， PESCINI F， RAFANELLI M， et al. Detection of subclinical atrial fibrillation after cryptogenic stroke using implantable cardiac monitors［J］. Eur J Intern Med， 2021， 92：86-93. doi:10.1016/j.ejim.2021.06.022 doi: 10.1016/j.ejim.2021.06.022
7	SCHNABEL R B， HAEUSLER K G， HEALEY J S， et al. Searching for Atrial Fibrillation Poststroke： A White Paper of the AF-SCREEN International Collaboration［J］. Circulation， 2019， 140（22）：1834-1850. doi:10.1161/circulationaha.119.040267 doi: 10.1161/circulationaha.119.040267
8	HINDRICKS G， POTPARA T， DAGRES N， et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery （EACTS）： The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology （ESC） Developed with the special contribution of the European Heart Rhythm Association （EHRA） of the ESC［J］. Eur Heart J， 2020， 42（5）：373-498. doi:10.1093/eurheartj/ehaa612 doi: 10.1093/eurheartj/ehaa612
9	LU Y， DIAO S S， HUANG S J， et al. Insertable cardiac monitors for detection of atrial fibrillation after cryptogenic stroke： a meta-analysis［J］. Neurol Sci， 2021， 42（10）：4139-4148. doi:10.1007/s10072-021-05104-6 doi: 10.1007/s10072-021-05104-6
10	NOUBIAP J J， AGBAEDENG T A， KAMTCHUM-TATUENE J， et al. Rhythm monitoring strategies for atrial fibrillation detection in patients with cryptogenic stroke： A systematic review and meta-analysis［J］. Int J Cardiol Heart Vasc， 2021， 34：100780. doi:10.1016/j.ijcha.2021.100780 doi: 10.1016/j.ijcha.2021.100780
11	NOUBIAP J J， THOMAS G， MIDDELDORP M E， et al. Atrial fibrillation detection using insertable cardiac monitor after stroke： A real-world cohort study［J］. J Cardiovasc Electrophysiol， 2023， 34（1）：142-146. doi:10.1111/jce.15744 doi: 10.1111/jce.15744
12	RATAJCZAK-TRETEL B， LAMBERT A T， AL-ANI R， et al. Underlying causes of cryptogenic stroke and TIA in the nordic atrial fibrillation and stroke （NOR-FIB） study - the importance of comprehensive clinical evaluation［J］. BMC Neurol， 2023， 23（1）：115. doi:10.1186/s12883-023-03155-0 doi: 10.1186/s12883-023-03155-0
13	ILIODROMITIS K， LENARCZYK R， SCHERR D， et al. Patient selection， peri-procedural management， and ablation techniques for catheter ablation of atrial fibrillation： an EHRA survey［J］. Europace， 2023， 25（2）：667-675. doi:10.1093/europace/euac236 doi: 10.1093/europace/euac236
14	FALASCONI G， PENELA D， SOTO-IGLESIAS D， et al. Personalized pulmonary vein antrum isolation guided by left atrial wall thickness for persistent atrial fibrillation［J］. Europace， 2023， 25（5）： euad118. doi:10.1093/europace/euad118 doi: 10.1093/europace/euad118
15	YAMAGUCHI Y， SOHARA H， TAKEDA H， et al. Long-Term Results of Radiofrequency Hot Balloon Ablation in Patients With Paroxysmal Atrial Fibrillation： Safety and Rhythm Outcomes［J］. J Cardiovasc Electrophysiol， 2015， 26（12）：1298-1306. doi:10.1111/jce.12820 doi: 10.1111/jce.12820
16	MASUDA M， ASAI M， IIDA O， et al. Additional low‐voltage‐area ablation in patients with paroxysmal atrial fibrillation： results of the randomized controlled VOLCANO trial［J］. J Am Heart Assoc， 2020， 9（13）：e015927. doi:10.1161/JAHA.120.015927 doi: 10.1161/JAHA.120.015927
17	SCHIAVONE M， GASPERETTI A， MONTEMERLO E， et al. Long-term comparisons of atrial fibrillation ablation outcomes with a cryoballoon or laser-balloon： A propensity-matched analysis based on continuous rhythm monitoring［J］. Hellenic J Cardiol， 2022， 65：1-7. doi:10.1016/j.hjc.2022.03.006 doi: 10.1016/j.hjc.2022.03.006
18	LEE S H， KIM T H， OH Y S， et al. Usefulness of an Implantable Loop Recorder in Diagnosing Unexplained Syncope and Predictors for Pacemaker Implantation［J］. J Korean Med Sci， 2020， 35（2）：e11. doi:10.3346/JKMS.2020.35.E11 doi: 10.3346/JKMS.2020.35.E11
19	SULKE N， SUGIHARA C， HONG P， et al. The benefit of a remotely monitored implantable loop recorder as a first line investigation in unexplained syncope： the EaSyAS Ⅱ trial［J］. Europace， 2016， 18（6）：912-918. doi:10.1093/europace/euv228 doi: 10.1093/europace/euv228
20	熊雁，刘明江，陶剑虹，等. 不明原因晕厥患者基于长程心电数据的病因分析［J］.中华心律失常杂志， 2023， 27（1）： 66-70.
21	LETSAS KP， SAPLAOURAS A， MILILIS P， et al. Diagnostic yield of implantable loop recorders： Results from the Hellenic registry［J］. Hellenic J Cardiol， 2024， S1109-9666（24）00108-8. doi:10.1016/j.hjc.2024.05.004 doi: 10.1016/j.hjc.2024.05.004
22	GIADA F， GULIZIA M， FRANCESE M， et al. Recurrent unexplained palpitations （RUP） study comparison of implantable loop recorder versus conventional diagnostic strategy［J］. J Am Coll Cardiol， 2007， 49（19）：1951-1956. doi:10.1016/j.jacc.2007.02.036 doi: 10.1016/j.jacc.2007.02.036
23	中华医学会心电生理和起搏分会，中国医师协会心律学专业委员会，中国房颤中心联盟心房颤动防治专家工作委员会. 心房颤动：目前的认识和治疗建议（2021）［J］. 中华心律失常学杂志， 2022， 26（1）：74. doi:10.3760/cma.j.cn113859-20211224-00264 doi: 10.3760/cma.j.cn113859-20211224-00264
24	POTPARA T S， LIP G Y H， BLOMSTROM-LUNDQVIST C， et al. The 4S-AF Scheme （Stroke Risk； Symptoms； Severity of Burden； Substrate）： A Novel Approach to In-Depth Characterization （Rather than Classification） of Atrial Fibrillation［J］. Thromb Haemost， 2021， 121（3）：270-278. doi:10.1055/S-0040-1716408 doi: 10.1055/S-0040-1716408
25	BRIOSA E GALA A， POPE M， LEO M， et al. Accuracy of AF burden detection with the new Confirm Rx with Sharp-sense technology［J］. EP Europace， 2022. DOI：10.1093/europace/euac053.173 . doi: 10.1093/europace/euac053.173
26	ASSAF A， THEUNS D， SAKHI R， et al. Accuracy of atrial fibrillation detection by an insertable cardiac monitor in patients undergoing catheter ablation： Results of the BioVAD study［J］. Ann Noninvasive Electrocardiol， 2022， 27（3）：e12960. doi:10.1111/anec.12960 doi: 10.1111/anec.12960
27	DE WITH R R， ERKüNER Ö， RIENSTRA M， et al. Temporal patterns and short-term progression of paroxysmal atrial fibrillation： data from RACE V［J］. Europace， 2020， 22（8）：1162-1172. doi:10.1093/europace/euaa123 doi: 10.1093/europace/euaa123
28	KAPLAN R M， KOEHLER J， ZIEGLER P D， et al. Stroke Risk as a Function of Atrial Fibrillation Duration and CHA（2）DS（2）-VASc Score［J］. Circulation， 2019， 140（20）：1639-1646. doi:10.1161/circulationaha.119.041303 doi: 10.1161/circulationaha.119.041303
29	王斌，胡丹，王芳芳. 血清尿酸及脑钠肽水平与射血分数保留心衰房颤患者房颤结构重构关系［J］. 实用医学杂志， 2023， 39（20）：2633-2637. doi:10.3969/j.issn.1006-5725.2023.20.014 doi: 10.3969/j.issn.1006-5725.2023.20.014
30	HINDRICKS G， POTPARA T， DAGRES N， et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery （EACTS）： The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology （ESC） Developed with the special contribution of the European Heart Rhythm Association （EHRA） of the ESC［J］. Eur Heart J， 2021， 42（5）：373-498. doi:10.1093/eurheartj/ehaa945 doi: 10.1093/eurheartj/ehaa945
31	张鹏祥，杜王，张郝，等. 抗凝治疗与房颤患者血浆神经源性外泌体中T⁃tau 蛋白和Aβ1⁃42含量变化的关系［J］. 实用医学杂志， 2022， 38（4）：459-463.
32	QURASHI A A AL， RASHEED F， SIDDIQI A R， et al. Insertable cardiac monitoring devices versus external cardiac monitoring for detecting atrial fibrillation and preventing the recurrence of stroke： A systematic review and meta-analysis［J］. J Electrocardiol， 2023， 77：29-36. doi:10.1016/j.jelectrocard.2022.11.007 doi: 10.1016/j.jelectrocard.2022.11.007
33	梁士楚，王翠，宋晨宇，等. 心房颤动射频消融术后长期抗凝可行性及安全性的Meta分析和试验序贯分析［J］. 中国循环杂志， 2020， 35（11）：1121-1128.
34	FRIBERG L， TABRIZI F， ENGLUND A. Catheter ablation for atrial fibrillation is associated with lower incidence of stroke and death： data from Swedish health registries［J］. Eur Heart J， 2016， 37（31）：2478-2487. doi:10.1093/eurheartj/ehw087 doi: 10.1093/eurheartj/ehw087
35	ARAI M， OKUMURA Y， NAGASHIMA K， et al. Adverse Clinical Events during Long-Term Follow-Up After Catheter Ablation of Atrial Fibrillation［J］. Int Heart J， 2019， 60（4）：812-821. doi:10.1536/ihj.18-517 doi: 10.1536/ihj.18-517
36	POTHINENI N V K， AMANKWAH N， SANTANGELI P， et al. Continuous rhythm monitoring-guided anticoagulation after atrial fibrillation ablation［J］. J Cardiovasc Electrophysiol， 2021， 32（2）：345-353. doi:10.1111/jce.14864 doi: 10.1111/jce.14864
37	WILLEMS S， BOROF K， BRANDES A， et al. Systematic， early rhythm control strategy for atrial fibrillation in patients with or without symptoms： the EAST-AFNET 4 trial［J］. Eur Heart J， 2022， 43（12）：1219-1230. doi:10.1093/eurheartj/ehab593 doi: 10.1093/eurheartj/ehab593
38	KUNISS M， PAVLOVIC N， VELAGIC V， et al. Cryoballoon ablation vs. antiarrhythmic drugs： first-line therapy for patients with paroxysmal atrial fibrillation［J］. Europace， 2021， 23（7）：1033-1041. doi:10.1093/europace/euab029 doi: 10.1093/europace/euab029
39	BERLIN S， GOETTE A， SUMMO L， et al. Assessment of OMT-28， a synthetic analog of omega-3 epoxyeicosanoids， in patients with persistent atrial fibrillation： Rationale and design of the PROMISE-AF phase Ⅱ study［J］. Int J Cardiol Heart Vasc， 2020， 29：100573. doi:10.1016/j.ijcha.2020.100573 doi: 10.1016/j.ijcha.2020.100573
40	CHU A F， RAJAGOPAL G， SARKAR S. The missing link： Unlocking the power of cardiac rhythm monitoring device based QT interval detection［J］. Pacing Clin Electrophysiol， 2022， 45（3）：401-409. doi:10.1111/pace.14431 doi: 10.1111/pace.14431
41	STOLEN C， ROSMAN J， MANYAM H， et al. Preliminary results from the LUX-Dx insertable cardiac monitor remote programming and performance （LUX-Dx PERFORM） study［J］. Clin Cardiol， 2023， 46（1）：100-107. doi:10.1002/clc.23930 doi: 10.1002/clc.23930
42	IBRAHIM O A， DREW D， HAYES C J， et al. Implantable loop recorders in the real world： a study of two Canadian centers［J］. J Interv Card Electrophysiol， 2017， 50（2）：179-185. doi:10.1007/s10840-017-0294-y doi: 10.1007/s10840-017-0294-y
43	AFZAL M R， MEASE J， KOPPERT T， et al. Incidence of false-positive transmissions during remote rhythm monitoring with implantable loop recorders［J］. Heart Rhythm， 2020， 17（1）：75-80. doi:10.1016/j.hrthm.2019.07.015 doi: 10.1016/j.hrthm.2019.07.015
44	DE COSTER M， DEMOLDER A， DE MEYER V， et al. Diagnostic accuracy of R-wave detection by insertable cardiac monitors［J］. Pacing Clin Electrophysiol， 2020， 43（5）：511-517. doi:10.1111/pace.13912 doi: 10.1111/pace.13912
45	CHENG Y-J， OUSDIGIAN KT， SARKAR S， et al. B-Po04-036 innovative artificial intelligence application reduces false pause alerts while maintaining perfect true pause alert sensitivity for insertable cardiac monitors［J］. Heart Rhythm， 2021， 18（8）：S293-S294. doi:10.1016/j.hrthm.2021.06.732 doi: 10.1016/j.hrthm.2021.06.732
46	TANKUT S S， HUANG D T， ZAREBA W， et al. Insertable cardiac monitor-guided early intervention to reduce atrial fibrillation burden following catheter ablation： Study design and clinical protocol （ICM-REDUCE-AF trial）［J］. Ann Noninvasive Electrocardiol， 2023， 28（2）：e13043. doi:10.1111/anec.13043 doi: 10.1111/anec.13043
47	QUARTIERI F， HARISH M， CALÒ L， et al. New insertable cardiac monitors show high diagnostic yield and good safety profile in real-world clinical practice： results from the international prospective observational SMART Registry［J］. Europace， 2023， 25（5）： euad068. doi:10.1093/europace/euad068 doi: 10.1093/europace/euad068

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Application effect of insertable cardiac monitorin atrial fibrillation monitoring

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