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WEDNESDAY Jun 9, 2021 (HealthDay News) – Norman Mayer, 86, walks with a computer chip in his chest and thinks of nothing.
Doctors implanted a tiny heart monitor chip in Mayer’s chest after he suffered a mini infection.Stroke in late 2015 to track his heartbeat and potentially detect an irregular heart rhythm called atrial fibrillation (a-fiction).
“You don’t even know what’s in there,” said Mayer, the incumbent mayor of the Camrose community in Alberta, Canada for the past 32 years. “It doesn’t bother you. It’s just part of life. “
But thanks to the chip, doctors were able to better track Mayer’s heartbeat and adjust his treatment to prevent another stroke, he said.
Mayer participated in one of two new clinical trials which show implantable a heart Monitor ICs are much more effective at detecting irregular heart rhythms than external devices that are now more commonly prescribed after stroke.
One trial found that the implanted monitor detected three times more atrial fibrillation than an external device that patients must carry, and in another trial it detected six times more atrial fibrillation.
The results represent “a dramatic increase in how often we find atrial fibrillation,” said Dr. Brian Buck, lead investigator for one of the clinical trials and a neuropathologist at the University of Alberta.
According to the US Centers for Disease Control and Prevention, atrial fibrillation increases a person’s risk of stroke by four to five times, and at least one in seven strokes is caused by an irregular heart rate.
A heavy heartbeat causes blood to accumulate and thicken in the upper chambers of the heart. If the clot makes its way to brain, it causes a stroke.
“We know that a-fibrillation is a high-risk condition for stroke,” said Dr. Don Kleindorfer, chair of the Department of Neurology at the University of Michigan School of Medicine. “We know that treating a-fib with anticoagulants reduces the risk by up to 80%.”
The problem is that atrial fibrillation is very similar to the noise your car makes – you can’t count on the noise that is generated when the car is being inspected by a mechanic.
Buck explained that “the rhythm disturbance can be present for a few minutes a month and then not appear for several months later, and then remain there for only a few hours, and then disappear again.”
He noted that stroke victims are usually given a portable monitor the size of a deck of cards that they can carry with them for 30 days. They place sticky electrodes on their breasts that are connected to a monitor that continuously records their heart rate.
But a month of follow-up is usually not enough, and patients believe the external monitor is causing real neck pain, Buck said.
“They actually hate carrying a loopback recorder with them,” Buck said. “Carrying an outer box with you for thirty days is really difficult. It greatly affects your ability to train, work, and the like. “
Therefore, two different research groups decided to test whether the implanted device would work better for tracking heart rate. The implant can track heart rate for up to three years and does not cause any hassle for patients.
Meyer said the device is easy to implant.
“It doesn’t really matter,” Mayer said. “I came in one morning, and they just take a little sharp knife and cut a piece for you, stick this thing in your chest, put on a patch and tell you to go home.”
A monitoring station installed on the counter transmitted the data captured by Mayer’s chip to the hospital, where neurologists analyzed it. signs of atrial fibrillation…
“I never got a call because of hesitation, but I talked fairly regularly with the girl who was in charge,” Mayer said. “They could track different bursts at different times of the day, depending on my activity or whatever. So they used it to adjust my medications so that blood thinners and for high blood pressure… “
Buck’s team found that doctors were able to detect signs of a-fibrillation in 15% of patients with the implant, compared with 5% with an external monitor among 300 people with recent strokes.
Another group, led by Dr.Richard Bernstein of the School of Medicine. Feinberg at Northwestern University in Chicago, showed even better results.
Chip detected atrial fibrillation in 12% of patients compared with about 2% found on external cardiac monitoring among nearly 500 recent stroke victims.
Experts said the implantable chips are approved for use in the US and Canada, but are still facing hurdles.
In Canada, the national health system requires a device to be proven cost-effective before the government pays for it, Buck said.
The implant costs more than $ 5,000 per patient, compared to roughly $ 1,000 for an external monitor, the researchers report in background notes.
“Before our healthcare system wants to pay for a device that costs several thousand dollars, we have to prove that it is cost effective,” Buck said. “It not only eliminates atrial fibrillation, but it also reduces stroke rates, improves patients’ quality of life and benefits the entire healthcare system.”
The same is true for insurance companies in the United States, which often object to both the cost of the device and the expense of cardiologists who must scrutinize the data for signs of lies, Kleindorfer said.
“A cardiologist somewhere has to read them over and over again,” said Kleindorfer. “The disadvantages are more related to insurance and finances, but it’s clear to me that an implantable monitor causes more confusion than an external one.”
Kleindorfer and Buck noted that none of the clinical trials were large enough to show that the devices actually prevent stroke. Further research will be needed to prove that implants can better protect people from stroke.
However, current evidence is compelling enough that the American Heart Association recommended monitoring a-fib in its recently updated guidelines for secondary stroke prevention, said Kleindorfer, who served as the lead author of the guidelines.
“In my mind as a clinician, of course, I would like to use an implantable monitor rather than an external one, because I find myself increasingly misleading and more forcing them to take anticoagulants, which should reduce the risk of stroke,” Kleindorfer said.
Both clinical trials were recently published in Journal of the American Medical Association…
U.S. Centers for Disease Control and Prevention atrial fibrillation…
SOURCES: Brian Buck, MD, a neurologist specializing in stroke, University of Alberta, Canada; Don Kleindorfer, MD, Head of the Department of Neurology, University of Michigan School of Medicine, Ann Arbor; Norman Mayer, 86, Camrose, Alberta, Canada; Journal of the American Medical Association, June 1, 2021
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