Article Navigation
Article Contents
-
Abstract
- < Previous
- Next >
Journal Article
, M Samuel Search for other works by this author on: Oxford Academic M Van Der Stoel Netherlands Heart Registration , Utrecht , Netherlands (The) Search for other works by this author on: Oxford Academic V Van Dijk St Antonius Hospital , Nieuwegein , Netherlands (The) Search for other works by this author on: Oxford Academic A Maass University Medical Centre Groningen , Groningen , Netherlands (The) Search for other works by this author on: Oxford Academic
On behalf of Device Registration Committee of the Netherlands Heart Registration
Funding Acknowledgements: Type of funding sources: None.
Author Notes
EP Europace, Volume 26, Issue Supplement_1, May 2024, euae102.666, https://doi.org/10.1093/europace/euae102.666
Published:
24 May 2024
- Split View
- Views
- Article contents
- Figures & tables
- Video
- Audio
- Supplementary Data
-
Cite
Cite
M Samuel, M Van Der Stoel, V Van Dijk, A Maass, Real-world evaluation of the treatment yield of implantable loop recorders (ILR) in the Netherlands, EP Europace, Volume 26, Issue Supplement_1, May 2024, euae102.666, https://doi.org/10.1093/europace/euae102.666
Close
Search
Close
Search
Advanced Search
Search Menu
Abstract
Background
Implantable loop recorders (ILRs) are invasive and expensive diagnostic tools used to determine the underlying arrhythmias associated with syncope and palpitations as well as capture atrial fibrillation (AF). The diagnostic and treatment yield from ILRs is uncertain. Prior studies indicated that 26-52% ILR patients were diagnosed with arrhythmias and 11-30% received subsequent treatment.
Purpose
Our primary aim was to determine the incidence of pacemaker and ICD implants within 1- and 3- years of ILR implantation. The secondary aims include 1) an evaluation of the incidence of AF ablation, 2) the identification of predictors for treatment, and 3) safety.
Methods
Adult patients who underwent an ILR implant in the Netherlands Heart Registration (NHR) Pacemaker and ICD registry (2018-2021) were included. The NHR device registry was linked to the ablation registry to determine the incidence of AF ablation after ILR. Incidence rates for pacemaker implants, ICD implants, AF ablations, and complications among ILR patients were reported as a proportion of ILR patients over 1- and 3- years. Predictors for treatment following an ILR were determined from multivariable logistic regression models.
Results
From 2018 to 2021, 11,961 patients underwent an ILR implant in the Netherlands. Patients who underwent ILR implantation were a median age 69 (IQR 56-77) years, 46.9% female, and 24.9% had AF. The most frequent indication for ILR implantation was syncope (76.2%), followed by palpitations (15.2%). At 1- and 3-years post-ILR implantation, 12.0% and 14.6% of ILR patients underwent a pacemaker implant, respectively (Figure 1). Fewer patients underwent ICD implants (0.9% and 1.3%) and AF ablation (1.3% and 1.8%) at 1- and 3-years post-ILR implantation, respectively (Figure 1). Compared to males, females were 28% and 70% less likely to undergo a pacemaker and ICD implant following ILR, respectively (Figure 2). Additional predictors for pacemaker implantation included older age, AF, and syncope (p<0.05 for all, Figure 2a). In addition to female sex, AF was a predictor of ICD implantation (Figure 2b). The incidence of complications was relatively low (0.3%). Infection was the most frequent complication (0.2%), followed by device dislocation (0.06%), bleeding (0.02%), and device defect (0.01%).
Conclusion
Despite the benefits of ILRs for long-term remote monitoring, the therapeutic yield of ILRs is relatively low with 14.6%, 1.3%, and 1.8% of ILR patients undergoing implantation for pacemakers, ICDs, and AF ablation at 3-years follow-up. As an expensive and invasive diagnostic tool, a more targeted approach for referrals is warranted to increase the therapeutic yield of the ILRs. Further investigations are warranted to determine the diagnostic yield of ILRs, regardless of subsequent invasive therapy.
Open in new tabDownload slide
Open in new tabDownload slide
This content is only available as a PDF.
Author notes
On behalf of Device Registration Committee of the Netherlands Heart Registration
Funding Acknowledgements: Type of funding sources: None.
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
Topic:
- artificial cardiac pacemaker
- syncope
- netherlands
- medical devices
- ablation
- implants
- implantable loop recorder
Issue Section:
Arrhythmias and Device Therapy > Arrhythmias, General > Diagnostic Methods
Download all slides
Advertisem*nt intended for healthcare professionals
Citations
Views
Altmetric
More metrics information
Metrics
Total Views 0
0 Pageviews
0 PDF Downloads
Since 5/25/2024
Citations
Powered by Dimensions
Altmetrics
Email alerts
Article activity alert
Advance article alerts
New issue alert
In progress issue alert
Receive exclusive offers and updates from Oxford Academic
Related articles in PubMed
Citing articles via
Google Scholar
-
Latest
-
Most Read
-
Most Cited
More from Oxford Academic
Cardiovascular Medicine
Clinical Medicine
Medicine and Health
Books
Journals
Advertisem*nt intended for healthcare professionals