Mar 3 2014
Like a third of all stroke patients, Barbara Manning of Chicago never knew what caused the medical event.
Now, Manning might be getting some answers as one of the first people in the United States living with a small cardiac monitoring device implanted under her skin. The device may provide clues into her stroke and how to possibly prevent another one.
Northwestern Medicine® electrophysiologist Rod Passman, MD, director of the Program for Atrial Fibrillation at the Bluhm Cardiovascular Institute, implanted the Medtronic Reveal LINQ Insertable Cardiac Monitor (ICM) System into Manning, 85, on February 24, 2014, the first implantation in the Midwest and one of the first in the nation.
The Reveal LINQ ICM is about one-third the size of a AAA battery, making it more than 85 percent smaller than other ICMs. While significantly smaller, the device is part of a system that allows physicians to continuously and wirelessly monitor a patient's heart for up to three years, with 20 percent more data memory than its larger predecessor.
While Reveal LINQ can monitor for palpitations or passing out episodes, it also helps doctors determine if patients suffer from atrial fibrillation, which can appear intermittently and without symptoms. Atrial fibrillation, the most common heart rhythm disorder, is a major cause of stroke but is difficult to detect.
"This device is constantly recording any abnormal rhythms of the heart," said Passman, who is also a professor of medicine-cardiology at Northwestern University Feinberg School of Medicine. "In the case of atrial fibrillation, wearable monitors and symptoms are often insufficient in helping us detect the abnormal heartbeat. This device is a major step forward in the care of certain patients with stroke or other medical problems that may be caused by rhythm problems of the heart."
Reveal LINQ, which is inserted through a syringe and sits permanently just under the skin, remotely sends daily updates on Manning's heart rhythms through a small bedside monitor to Northwestern Medicine doctors. If Manning travels, the monitor travels with her, allowing her to transmit her heart rhythms from anywhere in the world. Previous monitors transmitted the data through a wand device placed over the implant.
"When I had a slight stroke at the beginning of November, it was a big surprise to everyone, including my internist," said Manning, a mother of four and grandmother to seven who is an active art collector and world traveler. "No one could figure out why. They did many tests and nothing showed up. They put on a heart monitor that hung around my neck that was a heck of a lot bigger than what is going inside me. I'm hoping this will help provide some clues."
In addition to its continuous and wireless monitoring capabilities, physicians can request notifications to alert them if their patients have had cardiac events. The Reveal LINQ ICM is indicated for patients who experience symptoms such as dizziness, palpitation, fainting and chest pain that may suggest a cardiac arrhythmia, and for patients at increased risk for cardiac arrhythmias.
Placed just beneath the skin through a small incision of less than 1 cm in the upper left side of the chest, the Reveal LINQ ICM is nearly invisible to the naked eye once inserted. The device is placed using a minimally invasive insertion procedure and requires no sedation and no stitches.
"It's a relatively painless procedure that allows patients to be constantly monitored," Passman said. "I think this is really going to revolutionize monitoring and diagnosing heart rhythm disorders."
For more information about Reveal LINQ or the Bluhm Cardiovascular Institute, call (312) NM-HEART or visit heart.nmh.org.
Source: http://northwesternmedicine.org/