Changes in R-wave amplitude at implantation are associated with gender and orientation of insertable cardiac monitor: observations from the confirm Rx™ body posture and physical activity study
Abstract Background Insertable cardiac monitors (ICMs) are small subcutaneously implanted devices that detect changes in R-wave amplitudes (RWAs), effective in arrhythmia-monitoring. Although ICMs have proven to be immensely successful, electrical artefacts are frequent and can lead to misdiagnosis....
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-022-02752-0 |
| _version_ | 1817979706554712064 |
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| author | Matthew Swale Vincent Paul Sinny Delacroix Glenn Young Luke McSpadden Kyungmoo Ryu David Di Fiore Maria Santos Isabel Tan Andre Conradie MyNgan Duong Nisha Schwarz Stephen Worthley Stephen Pavia |
| author_facet | Matthew Swale Vincent Paul Sinny Delacroix Glenn Young Luke McSpadden Kyungmoo Ryu David Di Fiore Maria Santos Isabel Tan Andre Conradie MyNgan Duong Nisha Schwarz Stephen Worthley Stephen Pavia |
| author_sort | Matthew Swale |
| collection | DOAJ |
| description | Abstract Background Insertable cardiac monitors (ICMs) are small subcutaneously implanted devices that detect changes in R-wave amplitudes (RWAs), effective in arrhythmia-monitoring. Although ICMs have proven to be immensely successful, electrical artefacts are frequent and can lead to misdiagnosis. Thus, there is a growing need to sustain and increase efficacy in detection rates by gaining insight into various patient-specific factors such as body postures and activities. Methods RWAs were measured in 15 separate postures, including supine, lying on the right-side (RS) or left-side (LS) and sitting, and two separate ICM orientations, immediately after implantation of Confirm Rx™ ICM in 99 patients. Results The patients (53 females and 46 males, mean ages 66.62 ± 14.7 and 66.40 ± 12.25 years, respectively) had attenuated RWAs in RS, LS and sitting by ~ 26.4%, ~ 27.8% and ~ 21.2% respectively, compared to supine. Gender-based analysis indicated RWAs in RS (0.32 mV (0.09–1.03 mV), p < 0.0001) and LS (0.37 mV (0.11–1.03 mV), p = 0.004) to be significantly attenuated compared to supine (0.52 mV (0.20–1.03 mV) for female participants. Similar attenuation was not evident for male participants. Further, parasternally oriented ICMs (n = 44), attenuated RWAs in RS (0.37 mV(0.09–1.03 mV), p = 0.05) and LS (0.34 mV (0.11–1.03 mV), p = 0.02) compared to supine (0.48 mV (0.09–1.03 mV). Similar differences were not observed in participants with ICMs in the 45°-relative-to-sternum (n = 46) orientation. When assessing the combined effect of gender and ICM orientation, female participants demonstrated plausible attenuation in RWAs for RS and LS postures compared to supine, an effect not observed in male participants. Conclusion This is the first known study depicting the effects on RWA due to body postures and activities immediately post-implantation with an overt impact by gender and orientation of ICM. Future work assessing the cause of gender-based differences in RWAs may be critical. Trial registration: Clinical Trials, NCT03803969. Registered 15 January 2019 – Retrospectively registered, https://clinicaltrials.gov/NCT03803969 |
| first_indexed | 2024-04-13T22:45:57Z |
| format | Article |
| id | doaj.art-caec4d9298554479b6f57d711a880513 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-04-13T22:45:57Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-caec4d9298554479b6f57d711a8805132022-12-22T02:26:24ZengBMCBMC Cardiovascular Disorders1471-22612022-10-012211910.1186/s12872-022-02752-0Changes in R-wave amplitude at implantation are associated with gender and orientation of insertable cardiac monitor: observations from the confirm Rx™ body posture and physical activity studyMatthew Swale0Vincent Paul1Sinny Delacroix2Glenn Young3Luke McSpadden4Kyungmoo Ryu5David Di Fiore6Maria Santos7Isabel Tan8Andre Conradie9MyNgan Duong10Nisha Schwarz11Stephen Worthley12Stephen Pavia13The Valley Private HospitalSt. John of God Murdoch HospitalAbbottSt. Andrew’s HospitalAbbottAbbottFriendly Society Private HospitalSt. Andrew’s HospitalPerth MountFriendly Society Private HospitalGenesisCare, LeabrookGenesisCare, LeabrookSt. Andrew’s HospitalThe Wesley HospitalAbstract Background Insertable cardiac monitors (ICMs) are small subcutaneously implanted devices that detect changes in R-wave amplitudes (RWAs), effective in arrhythmia-monitoring. Although ICMs have proven to be immensely successful, electrical artefacts are frequent and can lead to misdiagnosis. Thus, there is a growing need to sustain and increase efficacy in detection rates by gaining insight into various patient-specific factors such as body postures and activities. Methods RWAs were measured in 15 separate postures, including supine, lying on the right-side (RS) or left-side (LS) and sitting, and two separate ICM orientations, immediately after implantation of Confirm Rx™ ICM in 99 patients. Results The patients (53 females and 46 males, mean ages 66.62 ± 14.7 and 66.40 ± 12.25 years, respectively) had attenuated RWAs in RS, LS and sitting by ~ 26.4%, ~ 27.8% and ~ 21.2% respectively, compared to supine. Gender-based analysis indicated RWAs in RS (0.32 mV (0.09–1.03 mV), p < 0.0001) and LS (0.37 mV (0.11–1.03 mV), p = 0.004) to be significantly attenuated compared to supine (0.52 mV (0.20–1.03 mV) for female participants. Similar attenuation was not evident for male participants. Further, parasternally oriented ICMs (n = 44), attenuated RWAs in RS (0.37 mV(0.09–1.03 mV), p = 0.05) and LS (0.34 mV (0.11–1.03 mV), p = 0.02) compared to supine (0.48 mV (0.09–1.03 mV). Similar differences were not observed in participants with ICMs in the 45°-relative-to-sternum (n = 46) orientation. When assessing the combined effect of gender and ICM orientation, female participants demonstrated plausible attenuation in RWAs for RS and LS postures compared to supine, an effect not observed in male participants. Conclusion This is the first known study depicting the effects on RWA due to body postures and activities immediately post-implantation with an overt impact by gender and orientation of ICM. Future work assessing the cause of gender-based differences in RWAs may be critical. Trial registration: Clinical Trials, NCT03803969. Registered 15 January 2019 – Retrospectively registered, https://clinicaltrials.gov/NCT03803969https://doi.org/10.1186/s12872-022-02752-0ArrhythmiaPostureGenderInsertable cardiac monitorR-wave amplitudesSyncope |
| spellingShingle | Matthew Swale Vincent Paul Sinny Delacroix Glenn Young Luke McSpadden Kyungmoo Ryu David Di Fiore Maria Santos Isabel Tan Andre Conradie MyNgan Duong Nisha Schwarz Stephen Worthley Stephen Pavia Changes in R-wave amplitude at implantation are associated with gender and orientation of insertable cardiac monitor: observations from the confirm Rx™ body posture and physical activity study BMC Cardiovascular Disorders Arrhythmia Posture Gender Insertable cardiac monitor R-wave amplitudes Syncope |
| title | Changes in R-wave amplitude at implantation are associated with gender and orientation of insertable cardiac monitor: observations from the confirm Rx™ body posture and physical activity study |
| title_full | Changes in R-wave amplitude at implantation are associated with gender and orientation of insertable cardiac monitor: observations from the confirm Rx™ body posture and physical activity study |
| title_fullStr | Changes in R-wave amplitude at implantation are associated with gender and orientation of insertable cardiac monitor: observations from the confirm Rx™ body posture and physical activity study |
| title_full_unstemmed | Changes in R-wave amplitude at implantation are associated with gender and orientation of insertable cardiac monitor: observations from the confirm Rx™ body posture and physical activity study |
| title_short | Changes in R-wave amplitude at implantation are associated with gender and orientation of insertable cardiac monitor: observations from the confirm Rx™ body posture and physical activity study |
| title_sort | changes in r wave amplitude at implantation are associated with gender and orientation of insertable cardiac monitor observations from the confirm rx™ body posture and physical activity study |
| topic | Arrhythmia Posture Gender Insertable cardiac monitor R-wave amplitudes Syncope |
| url | https://doi.org/10.1186/s12872-022-02752-0 |
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