Dr. Atul Verma, cardiologist at Southlake Regional Health Centre in Newmarket, Ontario, recently inserted the world’s smallest implantable cardiac monitoring device available – the Medtronic Reveal LINQ Insertable Cardiac Monitor System – in a patient. This was the first time the implant had been inserted in an adult in Canada.
The small, wireless device is designed to allow doctors to continuously monitor, and quickly and accurately diagnose patients who suffer from cardiac arrhythmias, or irregular heartbeats, that can lead to severe and unexplained fainting spells or stroke.
A made-in-Canada innovation and the smallest of its kind, at approximately one-third the size of a AAA battery, the Reveal LINQ monitor is more than 80 per cent smaller than other implantable cardiac monitors. Placed just beneath the skin through a tiny incision of less than 1 cm in the upper left side of the chest, the monitor is nearly invisible to the naked eye once inserted.
There are several technologies available that can help physicians diagnose patients who suffer from the effects of cardiac arrhythmias. Yet, these devices are only able to track a patient’s heart behaviour for a limited period of time, such as days or weeks. For some patients, this isn’t a problem because the majority of their symptoms occur within the required test window.
For 65-year-old Huntsville, Ontario resident Michael Smith, that window simply wasn’t long enough. Smith, a patient of the Heart Rhythm Program at Southlake, has been suffering from dizziness, nausea, and unpredictable and unexplained near-fainting spells for close to eight years.
Originally believed to have vertigo – a type of dizziness in which a patient inappropriately experiences the perception of motion – Smith saw a physiotherapist in his hometown to ease his symptoms. When that treatment yielded no results, he went back to the drawing board.
“When we ruled out vertigo, my doctor began to suspect I was suffering from a cardiac condition,” says Smith. “I could go months before I experienced symptoms again, and through all of the various tests I took, we were never able to actually capture a time when I was having an episode.”
Smith was referred to specialists at Southlake’s Regional Cardiac Care Program, an internationally renowned program that – fortunately for Smith – services residents in communities as far north as Muskoka. When he met with Dr. Zaev Wullfhart, electrophysiologist and physician leader of the Cardiac Program, Smith was identified as an ideal candidate for the Reveal LINQ monitor implant. On May 12, Smith became the second adult recipient at Southlake to have the implant inserted.
“Michael’s symptoms are so intermittent in nature,” explains Dr. Verma. “Using the new implant, we will be able to accurately and quickly identify the root cause of his condition when he next experiences a near-fainting spell.”
The device is placed using a minimally invasive insertion procedure, in as little as two minutes and on an outpatient basis, simplifying the experience for both physicians and their patients. Through a specialized and remote monitoring network, physicians can also request notifications to alert them if their patients have had cardiac events.
“The LINQ device is part of a powerful system that allows us to monitor a patient’s heart for up to three years, with 20 per cent more data memory than its larger predecessors,” says Dr. Verma.
The implantable cardiac monitor was originally invented by a Canadian physician, Dr. George Klein, as a result of collaboration between Dr. Klein and Medtronic of Canada, the manufacturer of the device. The prototype was developed in London, Ontario, and the first iteration was manufactured by Medtronic in Mississauga, Ontario. The monitor has evolved dramatically over time and the current version received Health Canada license in March 2014.
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“The Regional Cardiac Care Program at Southlake is no stranger to innovation,” said Dr. Dave Williams, Southlake president and CEO. “Time and again, the talented team of professionals who support our world-class program actively seek out opportunities to do things better, all with the goal to provide our patients with the absolute best the healthcare system has to offer. I commend Dr. Verma on his perseverance in making this happen for our patients, and I look forward to the possibilities that this new system brings with it.”
The introduction of the Reveal LINQ monitor provides physicians with the added ability to diagnose heart rhythm disorders that can be rare in their occurrence, but can still have dramatic and life-threatening impacts for a given patient. In April 2014, Emily DePaepe, a 13-year-old from southwestern Ontario, became the first person in Canada to receive the Reveal LINQ monitor. This procedure was performed by Dr. Elizabeth Stephenson, a cardiologist at The Hospital for Sick Children (SickKids).