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Implantable Loop Recorders after Atrial Ablation: Patient Compliance and Data Surveillance in Clinical Practice
Friederike Schlingloff, Martin Oberhoffer, Ines Quasdorff, Michael Schmoeckel, Stefan Geidel.
Asklepios Klinik St.Georg, Hamburg, Germany.

OBJECTIVE: Recent data suggest continuous monitoring by implanted loop recorder (ILR) as the “gold standard” for rhythm surveillance after atrial ablation. Studies describing patient compliance and pitfalls in the perioperative period are lacking. Aim of this study was to evaluate patient compliance and physicians time invested for obtaining data during the follow-up period after implanting an ILR.
METHODS: We prospectively collected data of patients undergoing implantation of an ILR for concomitant cardiac surgery and atrial ablation.Patient compliance was calculated as the ratio of incoming /expected data transmission.We documented physicians total time spent with pre- and postoperative explanation of the device and transmission tools, ILR activation, assistance on the phone after discharge, assessment of transmitted data and informing the general practitioner (GP) about results and discussion of treatment modifications.
RESULTS: Between 02/12 and 12/12 a total of 63 patients had an ILR implanted;44 patients were eligible for evaluating data until first transmission.The ratio of incoming/expected patient data transmission was 7/44(16%).36/44(82%)needed telephone or individual assistance,1patient was lost to follow-up. Mean time spent with ILR-related issues during hospital stay averaged 88±19 min. Mean number of necessary telephone calls was 6 ± 4 with an average time consumption of 10±4 min. Assessment of incoming data and information of the patient and GP took 72min (60-81min.) per patient. Overall, 220 ± 16 min on average per patient were needed for appropriate data acquisition, from implantation to first transmission of data.
CONCLUSIONS: In patients having an ILR after atrial ablation, compliance regarding data transmission was low. A substantial time effort during hospital-stay and close surveillance during follow-up period are necessary to obtain sufficient data on cardiac rhythm. Patient selection should be handled with care. Beneficial therapeutic decisions can only be expected when reliable data are obtained by efficient management.


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