Cardiology Advances


Advances in Cardiology and Heart Surgery

Probing the Predictive Capability of a Next Generation Implantable Cardiac Monitor

Elaine Wan, MD, is an invasive cardiac electrophysiologist with the Division of Cardiology at NewYork-Presbyterian/Columbia University Irving Medical Center and the Esther Aboodi Associate Professor of Medicine in Cardiology and Cardiac Electrophysiology at Columbia. As a physician-scientist and Director of Electrophysiology Research, Dr. Wan applies her expertise to developing novel treatments for patients with heart failure, vascular dysfunction, and arrhythmias. She also oversees all electrophysiology clinical trials at Columbia.

Dr. Elaine Wan

Dr. Elaine Wan

In March 2021, Dr. Wan was named as one of two national Principal Investigators, along with Scott Solomon, MD, Brigham and Women’s Hospital, for a nationwide 58-site clinical trial that is accumulating physiological measurement data and heart failure event data for use in designing and developing new diagnostic features for the LUX-Dx insertable cardiac monitor (ICM) system. This next generation loop recorder, LUX-Dx is expected to provide a chronic monitoring platform with advanced sensors for detecting heart arrhythmias, as well as heart failure. The device will record electrocardiograms, heart sounds, thoracic impedance, respiration, activity and night time heart rate. The diagnostic sensor data will be compared to clinical testing data and heart failure decompensation events.

“The study seeks to use an implantable loop recorder not only to diagnose heart arrhythmias, but also to diagnose patients with heart failure and to monitor them for any heart failure exacerbation.” — Dr. Elaine Wan

“We are excited to be a part of this trial, which is continuing to enroll patients. The study seeks to use an implantable loop recorder not only to diagnose heart arrhythmias, but also to diagnose patients with heart failure and to monitor them for any heart failure exacerbation,” says Dr. Wan. “The loop recorder is a small device no bigger than the size of half my pinky. It will allow us to use the sensors on this device, which was approved in 2020 by the FDA for rhythm monitoring, to also diagnose and monitor our heart failure patients who have either preserved ejection fraction or reduced ejection fraction. The study essentially encompasses all types of heart failure.”

The device is injected through a very small incision in a procedure that takes less than two minutes to perform. “Because the implantable loop recorder is underneath the skin patients do not have to worry about it coming off – it’s always with them, and it can be removed at any time,” says Dr. Wan.

“Previously, a loop recorder only had sensors for rhythm monitoring, which is still the current indication,” continues Dr. Wan. “The device is patient triggered. If a patient feels unwell, they can press a button and transmit information from the device to us. It also downloads data automatically. The next generation LUX-Dx has expanded the number of diagnostic sensors considerably. Analyzing the data from these sensors is expected to provide predictors of a possible heart failure exacerbation enabling physicians to treat patients aggressively before they need to be hospitalized. In one small device, we can obtain an abundance of information not only on heart arrhythmias, but also on the overall condition of the patient, their activity and exercise levels, their heart rate variability, and even the angle at which they sleep at night. For example, if a patient is requiring more pillows to sleep on, it may be a marker of increasing shortness of breath due to heart failure symptoms.”

“This type of remote monitoring for patients with cardiovascular disease is at the forefront of medicine, merging the expertise of electrophysiologists with heart failure specialists,” says Dr. Wan. She notes that what is particularly interesting about the LUX-Dx – as distinguishable from wearable monitors – is that digital technology is being used to risk stratify data from these sensors to identify which patients are most at risk of having a heart failure exacerbation. “The next goal at NewYork-Presbyterian will be to determine how we could apply this data to improve healthcare outcomes and prevent hospitalization. We will continue pursuing innovative and new technology at NewYork-Presbyterian that will help physicians to obtain real-time feedback on their patient’s heart condition from anywhere, anytime.”

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Dr. Elaine Wan


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