Diseases & Conditions

Einstein Cardiologist First in the City to Use New Cardiac Monitor

By on 12/21/2017

Some irregular heartbeats, known as arrhythmias, have catastrophic consequences, in large part because they’re difficult to diagnose and treat. Einstein cardiologists have begun using a new technology which, thanks to Bluetooth transmission, can more reliably identify a heart arrhythmia before it’s unmasked by a health crisis.

Sumeet Mainigi, MD, director of Electrophysiology at Einstein Medical Center Philadelphia, recently became the first in the city to implant a tiny cardiac monitor in a procedure that was brief and minimally invasive. The tiny monitor, called the SJM Confirm, is implanted by injection underneath the skin near the breast bone.

The device continuously monitors the patient’s heartbeat and rhythm. When it detects an abnormal heartbeat—whether the patient has symptoms or not—it transmits the information through a Bluetooth app on the patient’s phone so doctors can observe the arrhythmia in real time. Bluetooth is a wireless technology standard for exchanging data over short distances from fixed and mobile devices.

Erratic heartbeats sometimes can trigger stroke, heart attack and even sudden death. “One of the things that we struggle with is these are life-threatening conditions that we can’t screen for,” Dr. Mainigi said. “It could be that the patient is feeling a racing heart or palpitations which aren’t detected on an EKG and don’t show up on wearable monitors. Sometimes, the individual feels nothing at all. Oftentimes we discover the problem when a patient presents with a catastrophic event such as a stroke.”

“This provides a better diagnosis for people who may fall through the cracks otherwise.”—Sumeet Mainigi, MD

The new monitor, manufactured by St. Jude Medical, was recently approved by the FDA. Previous implantable monitors have been larger, could require deeper anesthesia, require a much bigger incision and had a more limited ability to record and transmit abnormalities to doctors. Then there are wearable external monitors, which can record real-time heartbeats, but they’re cumbersome and only viable for a short period of time. The injectable monitor can remain in place and function for several years. “The capability to transmit easily and continuously through the patient’s phone really does improve our ability to find these serious problems,” said Dr. Mainigi.

The St. Jude Medical website says the new monitor is for patients who experience “unexplained symptoms such as dizziness, palpitations, chest pain, syncope and shortness of breath, as well as patients who are at risk for cardiac arrhythmias.” Syncope is fainting due to a sudden drop in blood pressure.

Dr. Mainigi implanted the newly approved monitor in a patient who has already had a stroke, to determine whether atrial fibrillation—a common, and serious, arrhythmia—was the cause of the stroke and would require treatment to prevent a further crisis.

“It’s difficult to identify these problems,” Dr. Mainigi said. “This provides a better diagnosis for people who may fall through the cracks otherwise.”

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