Implantable STEMI monitor

Implantable STEMI monitor AngelMed Guardian system (Angel Medical Systems, Eatontown, New Jersey) is an implantable device which detects ischemic events using a pacemaker lead positioned at right ventricular apex [1]. The device detects ischemic events by analyzing shifts in ST segment. It compares ST deviation of a 10 second electrogram with baseline data. If the shift in ST segment is greater than the heart rate dependent programmable threshold, an emergency alert signal is generated. The implantable device gives a vibratory alert and an external associated device gives auditory and visual alert. ALERTS (AngelMed for Early Recognition and Treatment of STEMI) trial was a multicenter, randomized trial of the device [2]. Nine hundred and seven high risk acute coronary syndrome patients were randomized to a control group in which alarms are deactivated and a treatment group in which alarms were active, for a period of 6 months. Absence of system related complications was the primary safety endpoint. Composite primary efficacy endpoint was cardiac/unexplained death, new Q wave myocardial infarction or detection to presentation time of more than 2 hours. Safety was achieved with 96.7% freedom from system-related complications. Detection-to-door delay among the treatment group patients was 51 minutes. Detection-to-door time was more than 30 hours in the control group. Aggressive follow up with device interrogation was needed to capture all silent myocardial infarctions in the con...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Source Type: blogs