World’s Smallest Cardiac Monitor Can Provide Big Answers

Sometimes smaller is better. In fact, a heart monitor no bigger than a paper clip will eventually help doctors determine what caused 39-year-old Shannan Smith of Matteson to faint in early October.

“Some causes of fainting are due to causes that do not require aggressive medical or electrical device therapy,” explains interventional cardiologist Lokesh Chandra, M.D. “A detailed medical history and physical exam often are the best tools for helping make a diagnosis. Millions of dollars are spent on evaluation of fainting in the USA each year, and yet in many patients, no diagnosis is reached. In some patients there can be potentially life-threatening causes.”

Getting to the bottom of what caused an episode is crucial, but sometimes that’s easier said than done as at the time of the event most patients are at home on no monitor.

“A person who faints may go to the emergency department, see multiple doctors, undergo numerous tests over weeks or months and still not find out what is wrong,” he said, as by the time they reach the ER, the brief event has terminated and may not recur for days to months.

But thanks to a tiny implantable cardiac monitor now available at Ingalls, doctors can monitor a patient’s heart rhythm around the clock — for up to three years — to pinpoint if any cardiac arrythmia is the problem.

“Like its name suggests, the Medtronic ‘Reveal’ wireless cardiac monitor is designed to uncover abnormalities,” he said.

The tiny monitor is implanted beneath the skin with a syringelike device. But despite its small size, the Reveal packs a lot of power and can tell doctors if fainting or palpitations are due to a heart arrhythmia.

And that’s good news for Shannan.

The mother of two recently fainted in Dr. Chandra’s waiting room without explanation.

“As I was getting ready to go, I just hit the floor,” she recalls. “I knew I didn’t feel well. I’m just grateful it happened there.”

Dr. Chandra immediately dialed 911 and began lifesaving care. Within minutes, Shannan was rushed to the nearest hospital, where diagnostic testing was initiated.

After three days of testing ruled out a seizure and other obvious heart problems, Shannan was sent home. But what caused her to faint remained a mystery.

As she had done this before and prolonged monitoring had not revealed a cause, Dr. Chandra recommended the Reveal device.

Designed to detect arrhythmias that may be responsible for stroke and other potentially life-threatening conditions, the Reveal’s sensors and circuitry record every beat of the heart. The information it collects is stored on a memory chip and transmitted wirelessly to a patient’s doctor in the middle of the night for later review. The data is also analyzed by a computer programmed to look for erratic heart rhythms. Doctors can customize alerts, so if a patient’s heart rate gets to a certain level — too high or too low — the doctor gets an e-mail, page or phone call.

“The real benefit of implantable monitors is to spot something that doesn’t happen frequently, maybe once or twice a year,” Dr. Chandra said. “That can be especially useful for patients who pass out for no clear reason. We can’t keep patients in the hospital for days on end to do testing — or expect them to wear an uncomfortable external device for weeks either.”

The new technology at Ingalls is indicated for use as a diagnostic tool for people suffering from unexplained fainting, dizziness and palpitations for no clear reason. Reveal can also help doctors determine if a patient has atrial fibrillation — a leading risk factor for stroke — that can be very intermittent and asymptomatic.

The device itself is inserted under the skin in the chest through a small syringe. Patients are awake but sedated and go home the very same day.

Shannan says she’s relieved she has the device and is confident she will eventually get answers about what caused her to faint.

“I haven’t fainted at all since that episode, but now I know that if I start to feel funny or faint again, this device will record what happened, and I can be treated for it,” she said. “It’s like I’m under constant surveillance…but in a good way. I feel so blessed to benefit from this new technology and from Dr. Chandra’s expertise.”

Success Stories
  • Title

    Inspirational stories of courage and hope

Progress Magazine