this is what it is.. well where it is going and stuff...
NEW YORK (Reuters Health) - In patients with infrequent, unexplained heart palpitations, an implantable loop recorder is a safe and cost-effective tool for diagnosing the cause, according to a study conducted in Italy and reported in the Journal of the American College of Cardiology.
Dr. Antonio Raviele, from Umberto I Hospital in Venice, and associates enrolled 50 patients with palpitations that lasted for more than 1 minute, but occurred only once a month or less frequently, in the study if their initial evaluation was inconclusive.
Twenty-six patients underwent implantation of a loop recorder (Reveal Plus, Medtronic, Inc.) under local anesthesia. Twenty-four patients had conventional testing, including wearing a 24-hour Holter monitor and 1 month of ECG monitoring using an external recorder. An electrophysiological study was also conducted if indicated.
The implantable loop recorder is an automatically activated monitoring system that records an ECG during the heart palpitation. The device is implanted during a minimally invasive outpatient procedure and does not restrict the patient's activities.
A diagnosis was made in five patients in the conventional group within an average of 36 days, and in 19 in the implantable loop recorder group within an average of 279 days.
Nine of the 19 patients who were not diagnosed in the conventional group switched to the implantable loop recorder group, and a diagnosis was obtained in 6 of these patients.
Various diagnoses were made including rapid, irregular and slow heart beats affecting different chambers of the heart and conduction disorders.
During follow-up of at least 1 year, palpitations were completely eliminated in 22 patients with arrhythmias treated with a pacemaker, drugs or ablation (removal of a section of heart tissue), the investigators report. Drug treatment effectively reduced the frequency of palpitations in 8 patients.
Despite higher initial costs with the implantable loop recorder, the cost per diagnosis was 6,768 euros using the conventional approach and 3,056 euros when the implantable loop recorder was used
