Di Beibing, Liang Lifeng, Yang Wangyang, Zhang Nixiao, Liu Xiaona, Peng Hui, Sun Zhijun
Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of Cardiology, The Second People's Hospital of Hengshui, Hengshui, China.
BMC Cardiovasc Disord. 2025 Apr 7;25(1):267. doi: 10.1186/s12872-025-04707-7.
Insertable cardiac monitors (ICMs) are increasingly used for long-term electrocardiographic monitoring. However, the data on ICMs remains limited in China.
In this retrospective observational study, we evaluated the real-world use and outcomes of patients consecutively receiving Reveal LINQ (Medtronic Ltd, Minneapolis, MN) devices from 2020 to 2022 at the Cardiovascular Center of Beijing Friendship Hospital. Patient characteristics, ECG parameters, ICM indications and follow-up data were collected. The outcomes including symptom documentation, arrhythmia detection and ICM-guided interventions were identified.
A total of 200 patients (age 64 ± 14 years; 52% males) receiving ICMs were enrolled (134 syncopes, 59 unexplained palpitations, 7 cryptogenic strokes). During median follow-up of 28 months, 98 patients (49%) had documented clinically significant arrhythmia. After ICM diagnosis, 89 (44.5%) of patients had ICM-guided actionable events. Pacemaker/defibrillator implantation (48, 24%), catheter ablation (27, 13.5%) and mediation management (11, 5.5%) were the majority of ICM-derived management. For syncope, age > 65 years (HR 1.032, p = 0.017), asymptomatic sinus bradycardia (45-55 beats / min) (HR 2.106, p = 0.043) and RR interval exceeding 2 s (HR 3.625, p < 0.001) were significantly associated with actionable events. The risk of arrhythmia requiring management changes was significantly stepwise higher with the prevalence of more risk factors (P < 0.001 by log-rank).
ICM utilization is associated with high efficacy in diagnoses and triggers important and optimal management in China. Age > 65 years, asymptomatic sinus bradycardia (45-55 beats / min) and RR interval exceeding 2 s are independent clinical predictors of ICM-guided clinical management for syncope.
可植入式心脏监测器（ICM）越来越多地用于长期心电图监测。然而，在中国，关于ICM的数据仍然有限。
在这项回顾性观察研究中，我们评估了2020年至2022年在北京友谊医院心血管中心连续接受Reveal LINQ（美敦力公司，明尼阿波利斯，明尼苏达州）设备的患者的实际使用情况和结局。收集了患者特征、心电图参数、ICM适应症和随访数据。确定了包括症状记录、心律失常检测和ICM指导的干预措施在内的结局。
共有200例接受ICM的患者入组（年龄64±14岁；52%为男性）（134例晕厥、59例不明原因心悸、7例隐源性卒中）。在中位随访28个月期间，98例患者（49%）记录到具有临床意义的心律失常。ICM诊断后，89例（44.5%）患者发生了ICM指导的可采取行动事件。起搏器/除颤器植入（48例，24%）、导管消融（27例，13.5%）和药物治疗（11例，5.5%）是ICM衍生管理的主要方式。对于晕厥，年龄>65岁（HR 1.032，p = 0.017）、无症状窦性心动过缓（45 - 55次/分钟）（HR 2.106，p = 0.043）和RR间期超过2秒（HR 3.625，p < 0.001）与可采取行动事件显著相关。随着更多危险因素的出现，需要改变管理的心律失常风险显著逐步升高（对数秩检验P < 0.001）。
在中国，ICM的使用在诊断方面具有高效性，并能引发重要且最佳的管理措施。年龄>65岁、无症状窦性心动过缓（45 - 55次/分钟）和RR间期超过2秒是ICM指导的晕厥临床管理的独立临床预测因素。
