4 Early reports, though lacking in significant details, implicated MRI scans in the death of several patients with implanted devices. 3 However, there are major concerns that the static and gradient magnetic fields, and radiofrequency energy formed by MRI machines will interact with and cause malfunction of the device or permanent damage to the device, leads, or heart at the lead-tissue interface. 1,2 It is estimated that more than 50% of these patients will require magnetic resonance imaging (MRI) after device implantation. "While we are fortunate that there are a number of treatments and interventions for treating these conditions, the problem is finding those patients before they arrive at the hospital with a life threatening condition.Over 2 million patients in the United States have implanted devices, including pacemakers and implantable cardioverter-defibrillators (ICDs). "For 50 percent of people with atrial fibrillation there are no symptoms that suggest that they may have an arrhythmia," chief executive and founder of the Arrhythmia Alliance Trudie Lobban said in a statement. As well as monitoring for the type of condition behind this, the loop recorder will also be able to track exactly how the patient responds to different treatments. The patient that received the first implant is a 60-year-old man suffering from an irregular heartbeat. According to Medtrionic, around 6,500 are expected to be installed in the first year. Linker works at a department that specialises in implanting loop recorders and says they carry out about two or three procedures a week. It will constantly interrogate the device and upload the data to the internet, sending any abnormal rhythms securely and directly to the hospital where the doctor can view it on a dedicated website. The new device is wireless and every user is given a 3G enabled box they can place by their bed at home. Otherwise a "patient activator" could be used at home continuously or manually, but would need to be taken in to the doctor's. Previously, readings could only be taken at a doctor's surgery, with the patient exposed to a device that connects with the loop recorder through the skin. "What tends to happen is investigations are carried out and more tests are done - the average number of tests even if the implant is placed early is six to eight tests." Waiting lists would be rendered irrelevant if it becomes an outpatient procedure. But Linker says that in practice, this does not always happen. Because the device is recording all the time, we can view the heart rhythm at the time of symptoms."Įuropean guidelines state that a loop recorder should be implanted in these instances, to save on costly tests and investigations and diagnose faster. "It's unpredictable and someone can go weeks or months without episodes. "The problem is difficult to catch," says Linker. Linker explains there are commonly two reasons for repeatedly suffering from blackouts - either there's a problem in the brain or a problem with the heart, causing blood flow to the brain to stop (a common condition behind this is atrial fibrillation, which effects 800,000 in the UK). A loop recorder is recommended for anyone suffering from unexplained blackouts.
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