Current and Future Use of Insertable Cardiac Monitors

Abstract

Insertable cardiac monitors (ICMs) are small, subcutaneously implanted devices offering continuous ambulatory electrocardiogram monitoring with a lifespan up to 3 years. ICMs have been studied and proven useful in selected cases of unexplained syncope and palpitations, as well as in atrial fibrillation (AF) management. The use of ICMs has greatly improved our ability to detect subclinical AF after cryptogenic stroke, and application of this technology is growing. Despite this, current stroke and cardiology society guidelines are lacking in recommendations for monitoring of subclinical AF following cryptogenic stroke, including the optimal timing from stroke event, duration, and method of electrocardiogram monitoring. This focused review outlines the current society guidelines, summarizes the latest evidence, and describes current and future use of ICMs with an emphasis on detection of subclinical AF in patients with cryptogenic stroke.

Keywords: atrial fibrillation; cryptogenic stroke; implantable loop recorder; insertable cardiac monitor; syncope.