Home monitor alerts doctor to toddler’s paused heart rhythm

Syncope is the medical term for fainting, which can result in falls or even fatal accidents. Each year, six per cent of Canadians over the age of 10 experience syncope. Keeley Daley, a three-year old girl, has already experienced enough syncope for a lifetime.

Dominique Daley and her three-year old daughter Keeley were playing at the park in St. John’s. On their way home, Keeley tipped over like a chess piece and fell down. Her mother picked her up, brushed her off and they kept on walking. 10-steps later it happened again, just like the first time, without any warning. When they got inside the house it happened a third time. Dominique noticed that Keeley was sweating and her heart was racing so fast that she couldn’t count the heartbeats.


Dominique rushed Keeley to emergency at The Janeway Children’s Health and Rehabilitation Centre in St. John’s, Newfoundland and Labrador. Once admitted, they ended up under the care of cardiologist, Dr. Christina Templeton. The doctor ordered a battery of tests. Keeley’s EKG showed nothing abnormal but her EEG showed slowing in the left side of her brain.

Syncope is generally evaluated by doing a history and physical exam following the event, combined with a number of possible tests. However, after extensive testing by doctors, the mother and daughter were sent home without a diagnosis as to what caused the fainting.

Over the ensuing year, Dr. Templeton followed the young patient trying to diagnose the reasons for syncope. There were a couple of episodes and visits to the ER, but despite tests neither Neurology nor Cardiology were able to capture any information that would lead to a diagnosis.

Dr. Templeton decided to order a Medtronic Reveal LINQ Implantable Cardiac Monitor (ICM), a miniaturized ICM designed to help physicians diagnose irregular heart rhythms that may be infrequent or asymptomatic.


The Reveal LINQ ICM continuously monitors a patient’s heart rhythm, stores this data, and wirelessly transmits reports to physicians to help them determine a patient’s diagnosis and treatment plan.

Dr. Templeton implanted the monitor on Dec 19, 2014. The procedure happened right in Keeley’s bed in the pediatric intensive care unit. The doctor made a tiny incision (less than 1cm) and the ICM was inserted under the skin of the chest. Within six hours Keeley was up and running through the hall.

The Reveal LINQ ICM has the ability to continuously monitor and record heart activity. The data is then sent automatically to a patient’s physician each night over the secured Medtronic CareLink® Network using the MyCareLink™ Patient Monitor. The monitoring and reporting are completely automatic and require no patient involvement.

Over 14,000 Canadians with Medtronic implantable cardiac devices, including the one worn by Keeley, use the Medtronic CareLink Network as part of their device follow-up regimen.  This service allows patients to have a virtual visit with their cardiac device clinic versus travelling to their clinic.  The addition of Wireless CareAlerts has demonstrated an improvement in time to clinical action compared to standard in-person follow-up. Such was the case for Keeley.

Six days later, on the morning of December 25, 2014, Dr. Templeton received a text alert on her cell phone stating that an episode had occurred. When she logged into Medtronic’s CareLink Network website she discovered that Keeley had experienced a pause episode. This was the first time in the year since she had been seeing Keeley that Dr. Templeton was able to relate the young girl’s symptoms to heart rate.

Dr. Templeton called the mother and discovered that they were visiting family in Fort McMurray, Alberta.

Dr. Sean Connors at The Janeway Children’s Health and Rehabilitation Centre was consulted and arrangements were made to admit Keeley for a pacemaker implant when she returned home to St. John’s. The pacemaker was implanted. Having completed its task, the Reveal LINQ ICM was then removed. Going forward, Keeley will visit the pacemaker clinic twice a year for follow up.

The family has since moved fulltime to Calgary but Dominique will always remember the care and treatment of Dr. Templeton, someone she calls “the best cardiologist ever”.