14th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 2000

Jan. 29 - Feb. 5, 2000
Marilleva, Trento, Italy

S-109

Reveal^® Plus: a new tool for monitoring arrhythmia

N. Bottoni, L. Rapallini*, C. Menozzi on behalf of the Reveal Plus Clinical Investigators**.
S. Maria Nuova Hospital, Reggio Emilia, Italy, *Medtronic, Inc., **see Appendix

Abstract

BACKGROUND. Syncope often remains unexplained despite a complete diagnostic evaluation, because of its infrequent and unpredictable nature^1-3. The implantable loop recorder (ILR) represents a significant step forward in obtaining a symptom-rhythm correlation in patients with transient events⁴ that may suggest cardiac arrhythmias, such as unexplained syncope, dizziness, and unexplained recurrent palpitations⁵. However, some patients are incapable of using a patient-activated device. In addition, it has been demonstrated in clinical practice that up to 14% of the patients implanted with Reveal® ILR did not activate the ILR after an episode due to not carrying the activator with them during daily activities⁶.

DEVICE AND METHODS. We implanted 6 Reveal® Plus ILRs, Medtronic Inc., in recurrent, unexplained syncope patients. The patients had a mean of 3 syncopal episodes in the previous 12 months (median 3). This implantable device provides storage for both patient-activated and automatically detected (auto-activated) events.

CONCLUSIONS. During a mean follow-up of 95 days, no patients had an event. Auto activation serves to supplement patient activation and is designed to capture arrhythmic events automatically. It can be used in patients for whom non-compliance may be an issue. Reveal Plus ILR may improve the chance of capturing significant symptomatic arrhythmic events, but further follow-up is required to assess the diagnostic yield of the new tool.

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