Implantable loop recorder monitors heartbeats for El Pasoan with atrial fibrillation

July 14--A device a fraction of an inch long is providing George Saenz with a peace of mind he has never had before. Three weeks ago, the 67-year-old independent insurance agent had the Medtronic Reveal LINQ Insertable Cardiac Monitor (ICM) System -- also known as a loop recorder -- implanted in the skin above his heart.

The implantable device is the smallest implantable heart monitor available that records cardiac rhythms.

The single-lead device is used for diagnosis in patients with recurring unexplained episodes of palpitations and for long-term monitoring in patients at risk for or with documented atrial fibrillation (AF or A-fib).

"You really don't know anything is really wrong with you until something happens to you," Saenz said. "I didn't want to wait until it was too late."

About three years ago, Saenz was constantly feeling tired, so he went to see his doctor, who performed a cardioversion -- a procedure that can restore a fast or irregular heartbeat to a normal rhythm (an arrhythmia).

Earlier this year, Saenz had another episode and was taken to the emergency room at Las Palmas Medical Center.

Francisco Gonzalez, his cardiologist, diagnosed him with atrial fibrillation, the most common abnormal heart rhythm. It does not show symptoms, but is often associated with palpitations, fainting, chest pain, or congestive heart failure.

Everything was fine until a few months ago. While Saenz was on a treadmill at an out-of-town gym, he took a short break after two miles. When he returned, his pulse rate went from 84 to 184.

"I was exhausted but I was at a convention and I had to finish off the weekend," he said. "When I got back, I went to see Dr. Gonzalez and he was concerned that I was having these episodes. He didn't know how often I was having them. That's the whole idea behind this, to find out how often they occurred."

Three weeks ago, Gonzalez implanted the loop recorder device -- which is approximately one-third the size of a AAA battery, making it more than 80 percent smaller than other monitors -- just beneath the skin through an incision of less than 1 centimeter in the upper left side of Saenz's chest.

Las Palmas is the first hospital in El Paso to use this device. Juan Taveras, also a cardiologist who performs the procedure at Las Palmas.

"The device constantly monitors the patient's heart rhythms," said Jesse Olivares, director of cardiovascular services at Las Palmas. "The device is for patients who come in with feelings of flutter in their chest, irregular heart beats or if they have syncope, that's when you are sitting down and you get up too quickly and you start to feel dizzy."

Syncope is a temporary loss of consciousness caused by a fall in blood pressure.

"The device records everything the patient's heart does -- the regular beats, the irregular beats -- all day," Olivares said. "If a person wakes up real dizzy or their heart is feeling really strange, they can send the recorded data to the cardiologist who can then say, 'We need you to come in' or 'You need to go to the emergency room, now.'"

The patient can push a button on the monitor to note any instance when feeling ill. The doctor also has access to readouts that can alert them to irregularities in the patient.

Saenz, who has never had a heart attack, said using the loop recorder is a preventative measure.

"I have a brother who at 52 years old had open-heart surgery and I have another younger brother who had a stroke about two years ago," he said. "It gives me peace of mind that my heart is doing fine. If I am having those episodes, at least I know when they are happening and the doctor can go back and either change the medication or do something else."

This device is also beneficial to patients because it gives them confidence to remain active, even though they have AFib.

"The key is to stay active," Saenz said. "I walk three miles every morning without worry. I should be back up to five miles pretty soon."

Olivares said the cardiologist can also order an electrophysiology study to see exactly where along the conduction line of the heart are the abnormalities are heading and then treat those areas.

"Don't take things for granted," Olivares said. "If things don't feel right, go to your physician and say something that way they can start the work-up.

"It may have been a one-time event but with this, we know exactly when it happened. Without this type of technology, they could turn around and say, 'Oh, it just happened once and I'm OK.' But being able to identify the frequency of the episodes we can determine what the issues are."

The implantation process takes about 30 to 45 minutes. The device can be removed after three years if nothing abnormal is detected.

"This is for anybody who has started to feel changes in their heart rhythm," Olivares said. "We don't know what's happening in our bodies. It could come to the point where you have a stroke and it could have been detected six months earlier."

Victor R. Martinez may be reached at 546-6128.

--What: The implantable loop recorder (ILR) is a monitoring device used for diagnosis in patients with recurring unexplained episodes of palpitations or syncope and for long-term monitoring in patients at risk for or with documented atrial fibrillation (AF or A-fib).

--Where: Las Palmas Medical Center's Cardiovascular Services, 1801 N. Oregon.

--Information: 521-1295 or laspalmasdelsolhealthcare.com.

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