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Implantable Loop Recorders After Atrial Ablation: Patient Compliance and Data Surveillance in Clinical Practice

Schlingloff, Friederike MD; Oberhoffer, Martin M. MD; Quasdorff, Ines; Schmoeckel, Michael PhD; Geidel, Stephan MD

Innovations:Technology and Techniques in Cardiothoracic and Vascular Surgery: September/October 2013 - Volume 8 - Issue 5 - p 337–340
doi: 10.1097/IMI.0000000000000016
Original Articles

Objective Recent data suggest continuous monitoring by implanted loop recorder (ILR) to be the criterion standard for rhythm surveillance after atrial ablation. Studies describing patient compliance and pitfalls in the perioperative period are lacking. It was the aim of this study to evaluate patient compliance and time invested by physicians for obtaining data during the follow-up period after implanting an ILR.

Methods We prospectively collected data of 70 consecutive patients undergoing concomitant cardiac surgery, atrial ablation, and implantation of an ILR. Patient compliance was calculated as the ratio of incoming/expected data transmission. We documented total time spent by physicians with preoperative and postoperative supervision.

Results Between February 2012 and February 2013, a total of 70 patients had an ILR implanted; 49 of 70 patients were eligible for evaluation of data at 3-month follow-up. The ratio of incoming/expected data transmission was 12/49 (24%). The mean ± SD time spent with ILR-related issues during hospital stay was 88 ± 19 minutes. Assessment of incoming data and information of the patient and the general practitioner took 132 ± 13 minutes per patient. Overall, a mean ± SD of 220 ± 16 minutes per patient was needed for appropriate data acquisition, from implantation to first data transmission.

Conclusions In the patients having an ILR after surgical atrial ablation, initial compliance regarding data transmission was low. A substantial time effort was necessary to obtain sufficient data on cardiac rhythm. Device-related complications were observed. Patient selection should therefore be handled with care. Beneficial therapeutic decisions can be expected only when reliable data are obtained by efficient management.

From the Department of Cardiac Surgery, Asklepios Klinik St. Georg, Hamburg, Germany.

Accepted for publication September 12, 2013.

Friederike Schlingloff, MD, and Martin M. Oberhoffer, MD, contributed equally to this study.

Presented at the Annual Scientific Meeting of the International Society for Minimally Invasive Cardiothoracic Surgery, June 12 – 15, 2013, Prague, Czech Republic.

Disclosures: Friederike Schlingloff, MD, received funding for travel expenses and a grant for participation at the 2nd “Atrial Fibrillation Focus Group Meeting” sponsored by Medtronic, Inc, Minneapolis, MN USA. Martin M. Oberhoffer, MD, received funding for travel expenses from Medtronic, Inc, Minneapolis, MN USA. Ines Quasdorff; Michael Schmoeckel, PhD; and Stephan Geildel, MD, declare no conflicts of interest.

Address correspondence and reprint requests to Friederike Schlingloff, MD, Abteilung für Herzchirurgie, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099 Hamburg, Germany. E-mail:

©2013 by the International Society for Minimally Invasive Cardiothoracic Surgery