Revisiting where to apply preimplant mapping to improve P‐wave sensing of insertable cardiac monitors
Abstract Background Insertable cardiac monitors (ICMs) are used for long‐term cardiac rhythm monitoring. They have proven useful in diagnosing arrhythmias. They are conventionally inserted at the 4th intercostal space without preimplant mapping. Method We develop a new method, VisP, that finds an op...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-08-01
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| Series: | Journal of Arrhythmia |
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| Online Access: | https://doi.org/10.1002/joa3.12739 |
| _version_ | 1818173059939434496 |
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| author | Yuhei Kasai Jungo Kasai Syuichi Sahashi Sandeep Shakya Hiroki Kuji Naoki Hayakawa Kotaro Miyaji Junji Kanda |
| author_facet | Yuhei Kasai Jungo Kasai Syuichi Sahashi Sandeep Shakya Hiroki Kuji Naoki Hayakawa Kotaro Miyaji Junji Kanda |
| author_sort | Yuhei Kasai |
| collection | DOAJ |
| description | Abstract Background Insertable cardiac monitors (ICMs) are used for long‐term cardiac rhythm monitoring. They have proven useful in diagnosing arrhythmias. They are conventionally inserted at the 4th intercostal space without preimplant mapping. Method We develop a new method, VisP, that finds an optimal insertion position by applying the lightweight preimplant mapping to nine candidate positions beyond the conventional ones. We retrospectively analyze consecutive 60 patients who underwent ICM insertion (Reveal LINQ™) between April 2019 and March 2021 and compare the two groups with and without VisP. Results After 9 patients were excluded because of ectopic atrial rhythms or atrial fibrillation, 51 patients were analyzed. Thirty‐one patients underwent the conventional insertion (non‐mapping), whereas 20 patients underwent VisP. VisP achieved large P‐wave amplitudes while retaining the R‐wave amplitude for all patients; in contrast, P waves were not detected for 11 patients out of the 31 patients in the non‐mapping group (35%). On average, the P‐wave amplitude was 0.065 mV for VisP, compared to 0.029 mV for the non‐mapping group (p‐value< .001). The average R‐wave amplitude was 0.69 mV for VisP and 0.71 mV for non‐mapping (p‐value = .88), indicating the R‐wave difference is insignificant between the two groups. VisP selected the 4th, 3rd, and 2nd intercostal spaces for 7, 11, and 2 patients, respectively, meaning that 13 out of the 20 cases (65%) fell out of the conventional insertion location of the 4th intercostal space. Conclusions VisP improves the diagnostic ability of ICMs by finding an optimal position that yields reliable sensing of P waves while keeping high R‐wave sensing. |
| first_indexed | 2024-12-11T19:22:30Z |
| format | Article |
| id | doaj.art-af710603be9140909690d4d06e05c0ba |
| institution | Directory Open Access Journal |
| issn | 1880-4276 1883-2148 |
| language | English |
| last_indexed | 2024-12-11T19:22:30Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-af710603be9140909690d4d06e05c0ba2022-12-22T00:53:30ZengWileyJournal of Arrhythmia1880-42761883-21482022-08-0138462263210.1002/joa3.12739Revisiting where to apply preimplant mapping to improve P‐wave sensing of insertable cardiac monitorsYuhei Kasai0Jungo Kasai1Syuichi Sahashi2Sandeep Shakya3Hiroki Kuji4Naoki Hayakawa5Kotaro Miyaji6Junji Kanda7Department of Cardiology Kokuho Asahi Chuo Hospital Chiba JapanPaul G. Allen School of Computer Science & Engineering University of Washington Seattle WA USADepartment of Cardiology Kokuho Asahi Chuo Hospital Chiba JapanDepartment of Cardiology Kokuho Asahi Chuo Hospital Chiba JapanDepartment of Cardiology Kokuho Asahi Chuo Hospital Chiba JapanDepartment of Cardiology Kokuho Asahi Chuo Hospital Chiba JapanDepartment of Cardiology Kokuho Asahi Chuo Hospital Chiba JapanDepartment of Cardiology Kokuho Asahi Chuo Hospital Chiba JapanAbstract Background Insertable cardiac monitors (ICMs) are used for long‐term cardiac rhythm monitoring. They have proven useful in diagnosing arrhythmias. They are conventionally inserted at the 4th intercostal space without preimplant mapping. Method We develop a new method, VisP, that finds an optimal insertion position by applying the lightweight preimplant mapping to nine candidate positions beyond the conventional ones. We retrospectively analyze consecutive 60 patients who underwent ICM insertion (Reveal LINQ™) between April 2019 and March 2021 and compare the two groups with and without VisP. Results After 9 patients were excluded because of ectopic atrial rhythms or atrial fibrillation, 51 patients were analyzed. Thirty‐one patients underwent the conventional insertion (non‐mapping), whereas 20 patients underwent VisP. VisP achieved large P‐wave amplitudes while retaining the R‐wave amplitude for all patients; in contrast, P waves were not detected for 11 patients out of the 31 patients in the non‐mapping group (35%). On average, the P‐wave amplitude was 0.065 mV for VisP, compared to 0.029 mV for the non‐mapping group (p‐value< .001). The average R‐wave amplitude was 0.69 mV for VisP and 0.71 mV for non‐mapping (p‐value = .88), indicating the R‐wave difference is insignificant between the two groups. VisP selected the 4th, 3rd, and 2nd intercostal spaces for 7, 11, and 2 patients, respectively, meaning that 13 out of the 20 cases (65%) fell out of the conventional insertion location of the 4th intercostal space. Conclusions VisP improves the diagnostic ability of ICMs by finding an optimal position that yields reliable sensing of P waves while keeping high R‐wave sensing.https://doi.org/10.1002/joa3.12739Insertable cardiac monitorpreimplant mappingP‐wave sensingreveal LINQ™ |
| spellingShingle | Yuhei Kasai Jungo Kasai Syuichi Sahashi Sandeep Shakya Hiroki Kuji Naoki Hayakawa Kotaro Miyaji Junji Kanda Revisiting where to apply preimplant mapping to improve P‐wave sensing of insertable cardiac monitors Journal of Arrhythmia Insertable cardiac monitor preimplant mapping P‐wave sensing reveal LINQ™ |
| title | Revisiting where to apply preimplant mapping to improve P‐wave sensing of insertable cardiac monitors |
| title_full | Revisiting where to apply preimplant mapping to improve P‐wave sensing of insertable cardiac monitors |
| title_fullStr | Revisiting where to apply preimplant mapping to improve P‐wave sensing of insertable cardiac monitors |
| title_full_unstemmed | Revisiting where to apply preimplant mapping to improve P‐wave sensing of insertable cardiac monitors |
| title_short | Revisiting where to apply preimplant mapping to improve P‐wave sensing of insertable cardiac monitors |
| title_sort | revisiting where to apply preimplant mapping to improve p wave sensing of insertable cardiac monitors |
| topic | Insertable cardiac monitor preimplant mapping P‐wave sensing reveal LINQ™ |
| url | https://doi.org/10.1002/joa3.12739 |
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