Implantation of Loop Recorders in Coronary Heart Disease and Embolic Stroke
Diagnostische Bedeutung des Loop Recorders
- The American Heart Association recommends the use of an implantable loop recorder in patients with coronary heart disease and embolic stroke when the cause of the stroke remains unclear and there is a suspicion of paroxysmal atrial fibrillation 1, 2
- Implantable loop recorders have a significantly higher detection rate for atrial fibrillation compared to conventional monitoring (52% vs. 20%) in patients with cryptogenic stroke 3, 4
Indikationen für Loop Recorder bei KHK und Schlaganfall
- Loop recorders are particularly indicated when the mechanism of the embolic event remains unclear after thorough investigation and there is a high likelihood of identifying an arrhythmia as the cause 3, 5
- In patients with structural heart disease such as coronary heart disease and clinical or EKG features suggesting an arrhythmic cause, an implantable loop recorder is indicated 5, 4
Klinische Vorteile des Loop Recorders
- Continuous EKG recording for up to 24 months with high signal quality is possible with implantable loop recorders 6
- The loop recorder allows for activation after recovery of consciousness, enabling symptom-EKG correlation 6
- The long monitoring time increases the likelihood of symptom-EKG correlation 6
Therapeutische Konsequenzen
- Early detection of atrial fibrillation and initiation of oral anticoagulation can reduce the risk of further embolic events in patients with coronary heart disease and embolic stroke 2
- In patients with cardiac implantable electronic devices, recorded atrial high-frequency episodes (AHREs) should lead to further investigation to document clinically relevant atrial fibrillation and guide treatment decisions 1, 2