Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02087-y

Incidental rhythm disturbances and false positive findings in a large implantable loop recorder cohort following pulmonary vein isolation

S. Schlögl1, K. S. Schlögl1, P. Bengel1, H. Haarmann1, E. Rasenack1, G. Hasenfuß1, M. Zabel1, L. Bergau1

1Herzzentrum, Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen, Göttingen;

Introduction: Implantable loop recorders (ILR) are increasingly used for continuous rhythm monitoring following pulmonary vein isolation (PVI) for atrial fibrillation (AF). However, little is known about the incidence and the clinical impact of non-AFIB episodes recorded by the ILR in this specific patient population. Methods: We analyzed 219 consecutive patients implanted with an ILR following PVI between 2016-2022 in our center. Results: A total of 219 patients underwent Reveal LINQ™ implantation. We evaluated a mean 2.1±1.1 years patient follow up with a mean 822 events/patient (median 68 events/patient; range of events 0-13959; mean 1.05 events/day). A total of 49 patients (22.4%) developed a bradycardic event requiring medical intervention, 5 patients (2.3%) were later implanted with a pacemaker. Supraventricular tachycardia was observed by 4 patients (1.8%), one of them (0.4%) were ablated by an AVNRT, the others were ectopic atrial tachycardia treated conservatively. Sustained wide complex tachycardia was recorded in 4 patients, thereof, one patient received a secondary prophylactic implantable cardioverter defibrillator (ICD). In total 97 Patients (44%) showed more than 50000 episodes with false positive events (515 events/patient), 18.7% by undersensing and 13.6% with oversensing, 11.9% with both. Conclusion: Use of ILR for rhythm monitoring following PVI is feasible and might increase the early detection of further arrhythmic events. However, reduction of false positive events is necessary to optimize economic rhythm monitoring.

https://dgk.org/kongress_programme/ht2022/aP289.html