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A Single-center Experience Comparing First- Versus Second-generation Insertable Cardiac Monitors in Pediatric
Nathan Miller1, Lisa Roelle2, Dean Lorimer2
1Electrophysiology Laboratory, St. Louis Children's Hospital, St. Louis, MO, USA.
The Journal of Innovations in Cardiac Rhythm Management
|June 29, 2022
Summary
Advancements in insertable cardiac monitors (ICMs) show second-generation devices are increasingly used in pediatric patients. While first-generation ICMs offered quicker diagnosis, newer devices expand monitoring for inherited arrhythmia syndromes.
Area of Science:
- Cardiology
- Pediatric Electrophysiology
- Medical Device Technology
Background:
- Insertable cardiac monitors (ICMs) have evolved, with second-generation devices offering less invasive implantation.
- Understanding the differences between first- and second-generation ICMs in pediatric populations is crucial for optimizing patient care.
- Previous studies have not comprehensively compared pediatric ICM implant characteristics, indications, and diagnostic timelines.
Purpose of the Study:
- To compare first- and second-generation insertable cardiac monitors (ICMs) in pediatric patients.
- To analyze differences in implant indications and time to diagnosis between the two ICM generations.
- To evaluate the evolving role of ICMs in pediatric long-term cardiac monitoring.
Main Methods:
- Retrospective, single-center chart review of pediatric patients who underwent ICM implantation between 2009 and 2019.
- Data collected included patient demographics, medical history, implant indications, and time to diagnosis.
- Comparison between first-generation (surgical pocket) and second-generation (tool-assisted insertion) ICMs.
Main Results:
- A total of 208 pediatric patients were analyzed; 18% received first-generation ICMs and 82% received second-generation ICMs.
- Second-generation ICMs showed expanded indications, notably for inherited arrhythmia syndrome (IAS) management (40%) compared to first-generation (5%).
- Average time to diagnosis was shorter for first-generation ICMs (38 weeks) versus second-generation ICMs (55 weeks).
Conclusions:
- Second-generation ICMs are increasingly utilized in pediatric patients, reflecting technological advancements and broader application.
- While first-generation ICMs demonstrated a faster time to diagnosis, second-generation devices facilitate management of complex conditions like IAS.
- Innovations in ICM technology are expanding their utility for long-term remote monitoring in pediatric cardiology.
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