![]() PRD and DC reflect different facets of autonomic function and can therefore be used in combination to predict risk. Periodic repolarization dynamics (PRD) and heart rate deceleration capacity (DC) are clinically validated autonomic risk markers that provide strong and independent prognostic information in post-MI patients with LVEF >35%. There is a large body of evidence that presence of cardiac autonomic dysfunction after MI is associated with an increased susceptibility to malignant brady- and tachyarrhythmias eventually culminating in SCD. However, the majority of arrhythmic deaths after MI occurs in patients with LVEF >35% in whom no specific prophylactic strategies exist, indicating an important unmet medical need. Current guidelines recommend prophylactic ICD-implantation in post-MI patients with reduced left ventricular ejection fraction (LVEF ≤35%). Patients after myocardial infarction (MI) are at increased risk of SCD. Sudden cardiac death (SCD) is the most common single cause of death in the industrialized world. Why Should I Register and Submit Results?.Patients are instructed in use of the activator, and advised to schedule an appointment with their physician after using it so that information stored in the ILR can be retrieved for diagnosis. Bruising and discomfort in the implant area may persist for several weeks. Patients can go home the day of the procedure with few restrictions on activities. A pocket is created under the skin, and the ILR is placed in the pocket. A small incision (about 3–4 cm or 1.5 inches) is made just lateral to the sternum below the nipple line, usually on the patient's left side. The ILR is implanted by an electrophysiologist under local anesthesia. The remaining 30 minutes can be divided into a selectable number of slots for storage of manually triggered retrograde recordings as an answer to symptoms (fainting, palpitations etc) which may be caused by an arrhythmia. ![]() Thirty minutes is reserved for automatic storage of arrhythmias according preprogrammed criteria. New devices are able to store a total of 60 minutes of recordings on their memory. Because of the ILR's long battery life (up to 3 years), the heart can be monitored for an extended period. The ILR is a useful diagnostic tool to investigate patients who experience symptoms such as syncope (fainting), seizures, recurrent palpitations, lightheadedness, or dizziness not often enough to be captured by a 24-hour or 30-day external monitor. The technician or physician can download and review the recorded events during an office visit using a special programmer or via online data transmission. The ILR records by "freezing" the electrical information preceding, during and after the symptoms in the format of an electrocardiogram. The second way the ILR records is through a hand-held "patient activator" whereby the patient triggers a recording by pushing a button when they notice symptoms such as skipped beats, lightheadedness or dizziness. If the heart rate drops below, or rises above, the set rates, the ILR will record without the patient’s knowledge. First, recording may be activated automatically according to heart rate ranges previously defined and set in the ILR by the physician. Limited number of episodes of abnormal activity can be stored, with the most recent episode replacing the oldest. Abnormal electrical activity - arrhythmia is recorded by "freezing" a segment of the memory for later review. The ILR monitors the electrical activity of the heart, continuously storing information in its circular memory (henc the name "loop" recorder) as electrocardiograms (ECGs). ![]()
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