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Aim: Implantable loop recorders (ILRs) are now routinely implanted for long-term cardiac monitoring in the clinical setting. The aim of this study was to examine the real-world performance of these devices focusing on the management changes made in response to ILR-recorded data.
Methods And Results: This was a single-centre, prospective observational study of consecutive patients undergoing ILR implantation. All patients who underwent implantation of a Medtronic Reveal LINQ device from September 2017 to June 2019 at Barts Heart Centre were included. Five hundred and one patients were included. Three hundred and two (60%) patients underwent ILR implantation for an indication of pre-syncope/syncope, 96 (19%) for palpitations, 72 (14%) for atrial fibrillation (AF) detection with a history of cryptogenic stroke, and 31 (6%) for high risk of serious cardiac arrhythmia. The primary outcome of this study was that an ILR-derived diagnosis altered management in 110 patients (22%). Secondary outcomes concerned subgroup analyses by indication: in patients who presented with syncope/pre-syncope, a change in management resulting from ILR data was positively associated with age [hazard ratio (HR) 1.04, 95% confidence interval 1.02-1.06; P < 0.001] and negatively associated with a normal electrocardiogram at baseline (HR 0.54 [0.31-0.93]; P = 0.03). Few patients (1/57, 2%) aged <40 years in this group underwent device implantation, compared to 19/62 patients (31%) aged 75 years and over (P = 0.0024). Out of 183 (12%) patients, 22 in the 40-74 age range had a device implanted. Among patients who underwent ILR insertion following cryptogenic stroke, 13/72 (18%) had AF detected, leading to a decision to commence anticoagulation.
Conclusion: These results inform the utility of ILR in the clinical setting. Diagnoses provided by ILR that lead to changes in management are rare in patients under age 40, particularly following syncope, pre-syncope, or palpitations. In older patients, new diagnoses are frequently made and trigger important changes in treatment.
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http://dx.doi.org/10.1093/ehjqcco/qcab071 | DOI Listing |
Eur J Med Res
December 2024
Department of Cardiology, Xinqiao Hospital, Army Military Medical University, No. 83 Xinqiao Street, Shapingba District, Chongqing, 400037, China.
Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been proven to prevent decline in kidney function and failure. Whether SGLT2i affect the risk of contrast-associated acute kidney injury (CA-AKI) remains uncertain.
Methods: Use of SGLT2i was assessed in consecutive diabetics undergoing coronary angiography (CA) or percutaneous coronary intervention (PCI) from January 2020 to May 2023 at a tertiary hospital in Chongqing, China.
BMC Psychol
December 2024
Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
Background: Cognitive bias plays a crucial role in the onset and persistence of depression. Research has established a link between personality traits and cognitive bias; however, most of them focused on the general population, overlooking individuals with depression. We aim to explore the relationship between personality and cognitive bias in patients with major depressive disorder (MDD) and compare the results with healthy controls (HCs) to identify potential patterns.
View Article and Find Full Text PDFJ Orthop Surg Res
December 2024
The First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, Guangxi, China.
Background: Congenital radioulnar synostosis (CRUS) is a rare upper limb deformity characterized by impaired rotational movement of the forearm. Rotational osteotomy is a commonly employed surgical procedure for treatment. This study aimed to analyze its surgical efficacy in treating CRUS in children.
View Article and Find Full Text PDFJ Med Case Rep
December 2024
Department of Neurology, Los Angeles General Medical Center/University of Southern California, 1100 N. State St., Clinic Tower A4E, Los Angeles, CA, 90034, USA.
Background: The sunken flap or sinking skin flap syndrome is a complication that can be observed following decompressive craniectomy. More rare, sinking skin flap syndrome can occur as an iatrogenic complication of pleural effusion evacuation via chest tube placement in the presence of ventriculopleural shunt.
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J Transl Med
December 2024
Department of General Surgery, The Lu'an Affiliated Hospital of Anhui Medical University, Lu'an People's Hospital, Lu'an, 237000, China.
Gastric cancer remains a significant health burden globally, especially prevalent in Asian and European regions. Despite a notable decline in incidence in the United States and Western Europe over recent decades, the disease's persistence underscores the urgency for advanced research in its pathogenesis and treatment strategies. Central to this pursuit is the exploration of the mitogen-activated protein kinase (MAPK) pathway, a pivotal cellular mechanism implicated in the complex processes of gastric cancer development, including cellular proliferation, invasion, migration, and metastasis.
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