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New cardiac device records long-term data
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Dr. Arif Ahmad holds up an insertable cardiac monitor to give scale to the tiny device. (Times photo: Tom Holm)
MONROE - Monroe Clinic has begun implanting tiny heart monitoring devices to help diagnose patients who have fainting problems or other heart-related problems.

"It looks just like a dried out pimple after it's inserted," Dr. Arif Ahmad said.

Dr. Ahmad is a cardiologist and electrophysiologist at Monroe Clinic, where he has worked for about nine years. They started using the devices made by Medtronic about two weeks ago and have already performed two implants. The process involves a small incision before the device is inserted by a plunger. Ahmad said he tells his patients not to blink or they will miss the implant.

"It just literally takes a minute," he said.

The insertable cardiac monitor works 24/7 and its internal battery can last for up to three years. It's a slim, sleek-looking piece of machinery in the shape of a tie tack. The device monitors heart rate and can beam information wirelessly, directly to the doctor. Ahmad said he can have the information sent directly to his phone. Patients who use the device also have the option to push a button and have the monitor send information to their doctor. Ahmad said this is useful if the patient is experiencing an episode of light-headedness associated with fainting. He said the device helps doctors get real-time information to determine if symptoms are heart related. Ahmad said doctors can use the device if they are not sure what exactly is causing symptoms of fainting or seizures or arrythmia, which is an alteration in the rhythm of the heartbeat.

The device can typically detect what is wrong with the heart after a couple of weeks but Ahmad said they choose to keep it in for the full three years just in case.

"The rule of thumb is you want to burn it out," he said. "We don't take it out even if we know what the problem is, to be safe."

The insert isn't cheap. Ahmad said it is typically reimbursed by Medicare for about $12,000 to $15,000, but they haven't run into any problems with insurance not reimbursing the cost. Ahmad said the device is essential in determining the cause of a heart problem that can then be treated with other tools like pacemakers. Medtronic makes a miniature pacemaker as well, that can also be inserted into the body. It sends electrical impulses to the heart to synchronize and pace the heart to a desired rhythm. The pacemaker is about two inches wide and weighs about an ounce.

"Everything is getting leaner and meaner," Ahmad said.

Pacemakers and heart monitors can be programmed to react to certain types of heart rhythms. Ahmad said if a patient has unexplained fainting, they can insert the monitor and set it to see if the heart reaches over 180 beats per minute or under 20. Then doctors can know the fainting is a heart-related problem. Ahmad said once inserted, the devices are mostly hands-free.

"It pretty much has a mind of its own," he said.