An implantable loop recorder or smartphone based single-lead electrocardiogram to detect arrhythmia in adults with congenital heart disease?
BackgroundThe 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.MethodsBaseline and follow-up data of symptomatic ACHD patients w...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1099014/full |
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| author | Maarten A. Koole Maarten A. Koole Maarten A. Koole Dirkjan Kauw Kirsten M. Kooiman Joris R. de Groot Danielle Robbers-Visser Igor I. Tulevski Barbara J. Mulder Berto J. Bouma Mark J. Schuuring Mark J. Schuuring Mark J. Schuuring |
| author_facet | Maarten A. Koole Maarten A. Koole Maarten A. Koole Dirkjan Kauw Kirsten M. Kooiman Joris R. de Groot Danielle Robbers-Visser Igor I. Tulevski Barbara J. Mulder Berto J. Bouma Mark J. Schuuring Mark J. Schuuring Mark J. Schuuring |
| author_sort | Maarten A. Koole |
| collection | DOAJ |
| description | BackgroundThe 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.MethodsBaseline 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.ResultsIn 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.ConclusionNon-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. |
| first_indexed | 2024-04-11T00:38:19Z |
| format | Article |
| id | doaj.art-a061c93158824e8e9d33a19f0a7d46d4 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-11T00:38:19Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-a061c93158824e8e9d33a19f0a7d46d42023-01-06T13:41:43ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-01-01910.3389/fcvm.2022.10990141099014An implantable loop recorder or smartphone based single-lead electrocardiogram to detect arrhythmia in adults with congenital heart disease?Maarten A. Koole0Maarten A. Koole1Maarten A. Koole2Dirkjan Kauw3Kirsten M. Kooiman4Joris R. de Groot5Danielle Robbers-Visser6Igor I. Tulevski7Barbara J. Mulder8Berto J. Bouma9Mark J. Schuuring10Mark J. Schuuring11Mark J. Schuuring12Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, NetherlandsCardiology Centers of the Netherlands, Amsterdam, NetherlandsDepartment of Cardiology, Rode Kruis Ziekenhuis Beverwijk, Beverwijk, NetherlandsDepartment of Cardiology, Haga Teaching Hospital, The Hague, NetherlandsDepartment of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, NetherlandsDepartment of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, NetherlandsDepartment of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, NetherlandsCardiology Centers of the Netherlands, Amsterdam, NetherlandsDepartment of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, NetherlandsDepartment of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, NetherlandsDepartment of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, NetherlandsNetherlands Heart Institute, Utrecht, NetherlandsDepartment of Cardiology, UMC Utrecht, Utrecht, NetherlandsBackgroundThe 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.MethodsBaseline 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.ResultsIn 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.ConclusionNon-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.https://www.frontiersin.org/articles/10.3389/fcvm.2022.1099014/fullarrhythmiascongenital heart diseaseelectrocardiographytelemedicineimplantable loop recordercardiology |
| spellingShingle | Maarten A. Koole Maarten A. Koole Maarten A. Koole Dirkjan Kauw Kirsten M. Kooiman Joris R. de Groot Danielle Robbers-Visser Igor I. Tulevski Barbara J. Mulder Berto J. Bouma Mark J. Schuuring Mark J. Schuuring Mark J. Schuuring An implantable loop recorder or smartphone based single-lead electrocardiogram to detect arrhythmia in adults with congenital heart disease? Frontiers in Cardiovascular Medicine arrhythmias congenital heart disease electrocardiography telemedicine implantable loop recorder cardiology |
| title | An implantable loop recorder or smartphone based single-lead electrocardiogram to detect arrhythmia in adults with congenital heart disease? |
| title_full | An implantable loop recorder or smartphone based single-lead electrocardiogram to detect arrhythmia in adults with congenital heart disease? |
| title_fullStr | An implantable loop recorder or smartphone based single-lead electrocardiogram to detect arrhythmia in adults with congenital heart disease? |
| title_full_unstemmed | An implantable loop recorder or smartphone based single-lead electrocardiogram to detect arrhythmia in adults with congenital heart disease? |
| title_short | An implantable loop recorder or smartphone based single-lead electrocardiogram to detect arrhythmia in adults with congenital heart disease? |
| title_sort | implantable loop recorder or smartphone based single lead electrocardiogram to detect arrhythmia in adults with congenital heart disease |
| topic | arrhythmias congenital heart disease electrocardiography telemedicine implantable loop recorder cardiology |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1099014/full |
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