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Published on: February 28, 2012
An anatomic-based approach for the placement of implantable loop recorders
Blair P Grubb1, Marlene Welch, Khalil Kanjwal
1Department of Medicine, Department of Surgery, University of Toledo, Toledo, OH, USA. blair.grubb@utoledo.edu
Pacing and Clinical Electrophysiology : PACE
|April 1, 2010
Summary
A simple anatomic approach for implantable loop recorder (ILR) placement eliminates the need for preoperative skin mapping. This method ensures adequate electrocardiographic tracings for effective cardiac monitoring.
Area of Science:
- Cardiology
- Medical Devices
- Surgical Procedures
Background:
- Traditional implantable loop recorder (ILR) placement requires preoperative cutaneous mapping to identify the optimal position.
- This mapping process can be time-consuming and may not always be necessary.
Purpose of the Study:
- To evaluate a simplified, anatomy-based approach for implantable loop recorder (ILR) placement.
- To determine if this method eliminates the need for preoperative cutaneous mapping while maintaining adequate signal quality.
Main Methods:
- A cohort of 63 patients underwent Reveal implantable loop recorder (ILR) implantation using a standardized anatomic landmark in the left upper chest.
- No preoperative cutaneous mapping was performed prior to device implantation.
- Patients were followed for an average of 10 months post-implantation.
Main Results:
- Adequate electrocardiographic tracings were achieved in all 62 evaluated patients immediately after implantation without mapping.
- Signal amplitudes (P wave and QRS complex) remained stable from implant to follow-up (6-14 months).
- Minor issues, including two cases of undetected P waves and two instances of inappropriate device activation/oversensing, were noted.
Conclusions:
- A straightforward anatomic approach is effective for implantable loop recorder (ILR) placement.
- This method simplifies the implantation procedure by removing the requirement for preoperative cutaneous mapping.
- The anatomic approach yields adequate diagnostic signal quality for long-term cardiac monitoring.
