Managing Patients with Heart Arrhythmia - Episode 9

Future of Long-Term Monitoring Solutions for Afib and Syncope

An expert in cardiovascular medicine provides insight on long-term monitoring solutions in the pipeline for the management of atrial fibrillation and syncope.

Solomon J. Sager, MD: Where do we stand today? We have wearable monitors—insertable cardiac monitors—as the mainstay of monitoring devices. What’s in the pipeline and what do we see for the future? A lot of what’s going on in the future of cardiac monitoring revolves around patient-centered data collection. The FDA has approved multiple algorithms in wearable devices such as Apple Watches, Fitbits, and the [AliveCor] KardiaMobile app. This technology allows patients to collect their own information and send it to doctors with the push of a button.

There are many benefits to patient-centered data collection, but there are also pitfalls. If a patient is having silent arrhythmias that they don’t know about or that their device is unable to detect, we won’t be able to see those data. The newer insertable cardiac monitors coming out have longer battery lives. In the future, we should be able to get real-time information via Bluetooth connections with patients, phones, and watches. And they’re adding uses to the insertable cardiac monitors. Some of them are able to check body temperature as well as thoracic impedance to determine if patients have extra fluid in their lungs that may be causing shortness of breath.

As I see it, the future for insertable cardiac monitors means more data collection, which will allow for more ways to take care of patients from the comfort of their own home without coming into the office or the hospital. The future for medicine and for cardiology is being able to take care of people without them coming into the office. The COVID-19 pandemic taught us that telemedicine is the future and insertable cardiac monitors are a powerful tool to help us deliver on our promise to patients to be able to take care of them without them coming into the office or the hospital. Most important, being able to take care of people at home means keeping them out of the hospital environment and within the comfort of their homes.

Which insertable cardiac monitor is the best? All of them have their benefits. The main ones on the market are made by Medtronic, Boston Scientific, Abbott, and Biotronik. Each company has its own benefits and pitfalls. Personally, I use Medtronic’s more because I find that the implantation technique is the easiest and the data collection is the most powerful. But the others have their own benefits. Boston Scientific devices are universally connected via Bluetooth to the patient’s phones. Biotronik has multiple ways of collecting other information, such as body temperature, on their devices, and they have a longer battery life. All of them are excellent devices and can be used for appropriate patient monitoring and data collection.

Transcript Edited for Clarity