Recently, the team of Director Jin Long and Deputy Director Zhang Zanwei of the Third Department of Cardiology successfully implanted the first implantable electrocardiogram event monitor (ICM) in the Ninth Hospital of the Municipal Ninth Hospital, namely the 3T-compatible long-range ECG monitor RevealLINQ, which is often referred to as the implantable holter.
91-year-old Grandpa Wei, a veteran of the War to Resist US Aggression and Aid Korea, had episodic amaurosis and syncope for more than 1 year, long-term bradycardia, heart rate fluctuations of 38-55 beats per minute, and no obvious abnormalities were found in multiple hospitalizations for head MRI and neck vascular color ultrasound. In view of the unpredictability of syncope, it is difficult to catch it in routine examination, and repeated syncope causes great trouble to the patient's daily life, so after full communication, it was decided to implant ICM for the patient, and the patient was discharged on the second day after surgery.
Make small incisions using a LINQ-specific incision knife
Insert the LINQ implant device
Rotate 180 degrees
Stitch 1 stitch
The small incision is only 0.7cm, and the surgery is completed efficiently in 10 minutes
The specific location and size of the ICM implant
1. What is an implantable electrocardiogram event detector (ICM)?
An implantable ECG event monitor (ICM), also known as an implantable cardiac recorder, is a single-lead ECG monitoring device implanted under the skin that detects arrhythmias in a timely manner and automatically stores the recorded ECG data.
2. Who is suitable for ICM implantation?
1. Unexplained syncope: It can be determined whether recurrent episodes of unexplained syncope are associated with arrhythmias, and cardiogenic syncope is the most dangerous of all types of syncope.
2. Occult stroke: determine whether asymptomatic atrial fibrillation exists in patients with occult stroke. Large studies have shown that atrial fibrillation is found in about 30% of patients with occult stroke with long-term surveillance.
3. Screening and management of atrial fibrillation: With the aging of the population, the prevalence of atrial fibrillation is increasing year by year. Studies have shown that about 40% of patients with atrial fibrillation have no clinical manifestations, and about 25% of patients have a stroke as the only clinical manifestation. ICM has an accuracy rate of 99.4% for the detection of atrial fibrillation.
3. What are the advantages of ICM?
ICM is like a detective hidden in the body, on call around the clock, ready to find out the life-threatening psychogenic "culprit", like an ECG version of the "dash cam".
1. High detection rate: greatly improve the detection rate of arrhythmic events. It can clarify the relationship between syncope symptoms and arrhythmias, and has become an effective means of diagnosing unexplained syncope. Compared with conventional short-term Holter ECG, the ICM detection rate at 12 months was 7.3 times higher than that of routine diagnosis.
2. Easy installation: only local anesthesia is required, and the risk of trauma is small.
3. Good compliance: Compared with traditional ECG monitoring equipment such as ambulatory ECG, it has the characteristics of smaller size and better compliance.
4. Long monitoring time: Compared with traditional ECG monitoring equipment such as Holter ECG, ICM can monitor arrhythmia for a long time and store the recorded ECG data.
4. How should ICM be followed?
The first follow-up visit should be completed 1 month after ICM implantation, and then every 3 months or half a year, and the follow-up analysis can be carried out immediately at any time due to the occurrence of active activation events of the patient.
The implantable electrocardiogram monitor (ICM) is small and delicate, easy to implant, and can accurately record malignant arrhythmias such as atrial fibrillation, ventricular tachycardia, ventricular fibrillation, bradycardia, and cardiac arrest, and can work continuously for 36 months, which can preserve the key evidence of arrhythmia. It effectively solves the problems of short Holter monitoring time, discontinuous monitoring, and poor compliance. Guarding our hearts around the clock, once a fatal arrhythmia is found, it will give an immediate warning, so that doctors and patients can know in advance, intervene early, and effectively reduce the risk of sudden death.
Chinese business all-media reporter Chen Mengyang