The second event was 44 beats in duration, ranging between 220 and 240 bpm. Both events were wide variable complex tachycardia that was preceded by bradycardia. Within 1 month of implantation he manually triggered the device during his practice and two episodes of tachycardia were detected during the 8-minute transmission. Due to the difficulty in obtaining event recordings during practice, an ILR (Medtronic Linq, Minneapolis, MN) was placed. The first patient is a 21-year-old collegiate diver who presented with recurrent infrequent palpitations that occurred while performing training exercises. The ILR proved useful in the accurate diagnosis and appropriate management of both athletes, underscoring the value of these devices in this special population. This case report highlights the diagnostic value of an implantable loop recorder (ILR) in two elite athletes, one with recurrent palpitations, the other with a history of bradycardia and syncope. 1 Thus, prompt evaluation of an athlete with a possible arrhythmia as the cause is warranted. Sudden cardiac arrests in athletes are high-profile events and the risk of sudden cardiac arrest has been shown to be greater in athletes versus the general population. Manuscript received March 14, 2016, Final version accepted May 9, 2016.Īddress correspondence to: Ian Law, MD: Stead Family University of Iowa Children’s Hospital, 200 Hawkins Drive, Iowa City, IA 52242–1083. The authors report no conflicts of interest for the published content. loop recorders, supraventricular tachycardia, ventricular tachycardia. In both instances, the ILR facilitated a diagnosis, which ultimately lead to appropriate and timely management. Here we highlight the value of the implantable loop recorder (ILR) using two cases involving collegiate athletes. In order to reduce mortality without unnecessarily taking healthy athletes away from competition, a useful diagnostic test is needed. Sudden cardiac arrests in athletes due to arrhythmias have become much more high profile, and the relative risk of sudden cardiac death has been shown to be greater in athletes when compared to non-athletes. The University of Iowa Children’s Hospital, Division of Pediatric Cardiology, Iowa City, IAĪBSTRACT. If immediate evaluation of the transmission is needed, then a phone call must be placed to our office to alert us about the transmission.A Tale of Two Athletes: The Value of Implantable Loop Recorders in Elite AthletesĪNDREW HULL, BS, FRANK CANADY, BA, PRASHANT BHAVE, MD and IAN LAW, MD Additionally, they can manually send an immediate transmission by pressing the button on the transmitter. If patients are experiencing any concerning symptoms, they can force a recording using their remote.In these cases, we evaluate the findings each month when we receive a full record of what happened during that entire period. In other circumstances, we want to evaluate the burden of arrhythmia or the response of an arrhythmia to medication or ablation: how often do episodes occur, how long are the episodes, etc.If for any reason the arrhythmia is not detected during these alerts, each month we receive and evaluate a full listing of the events during that period. However, this requires an excellent daily transmitter connection. For some conditions (for which we set the highest level of alert), when there is evidence of an arrhythmia, we are notified within 24-48 hours, and then patients or their physician are contacted to discuss the findings and the type of action required.We evaluate and address transmissions that meet the criteria of special alerts we set up depending on each patient’s diagnosis and the reasons we implanted the recorder. As there are many patients with these types of devices in our practice, obviously we cannot evaluate everyday transmissions with no abnormalities.The transmitter sends the recorded data to our monitoring company, which provides services 24/7/365.The entire system is wireless, and usually when patients go to bed at night, the monitor communicates with a transmitter, which must be close to the bedside.Data is automatically recorded and transmitted, so patient involvement is close to zero. The patient doesn’t need to do anything.
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