Diagnostic yield of an insertable cardiac monitor in a large patient population

BACKGROUND Insertable cardiac monitors (ICMs) are increasingly used for cardiac rhythm diagnosis with expanding indications. Little has been reported about their use and efficacy.OBJECTIVE The study sought to evaluate the clinical utility of a novel ICM (Biotronik BIOMONITOR III) including the time to diag-nosis in unselected patients with different ICM indications.METHODS Patients from 2 prospective clinical studies were included to determine the diagnostic yield of the ICM. The primary endpoint was time to clinical diagnosis per implant indication or to the first change in atrial fibrillation (AF) therapy.RESULTS A total of 632 patients were included with a mean follow-up of 233 6 168 days. Of 384 patients with (pre)syncope, 34.2% had a diagnosis at 1 year. The most frequent therapy was permanent pacemaker implantation. Of 133 patients with cryptogenic stroke, 16.6% had an AF diagnosis at 1 year, resulting in oral anticoagula-ion. Of 49 patients with an indication for AF monitoring, 41.0% had a relevant change in AF therapy based on ICM data at 1 year. Of 66 patients with other indications, 35.4% received a rhythm diagnosis at 1 year. Moreover, 6.5% of the cohort had additional diagnoses: 26 of 384 patients with syncope, 8 of 133 patients with cryptogenic stroke, and 7 of 49 patients with AF monitoring.CONCLUSION In a large unselected patient population with het-erogeneous ICM indications, the primary endpoint of rhythm diag-nosis was achieved in w1 in 4, and additional clinically relevant findings was achieved in 6.5% of patients at short-term follow-up.