Does your patient have a history of syncope? Palpitations? Atrial fibrillation? Atrial flutter ablation? Implant an implantable loop recorder (ILR)! These sexy little devices can practically be injected into the patient, have a 3 year battery longevity, and will be so automated you won’t even need a human to report findings.

Ok, perhaps my tone is a tad sarcastic but when we first started implanting these, that was essentially the sales pitch I had received. I was told the patient won’t need in clinic visits and that their monitor would download all the necessary data to make a diagnosis. Either I’m a skeptic at heart or it’s a trait I’ve developed working in cardiac rhythm management. I know the CRM giants are excited about new technology. And, I know most of the doctors can’t wait to utilize this phenomenal new gadget!

Hey! But what about us? The end user? The gatekeepers of data? We are drowning in the massive volume of ‘noise’ and false data. Many clinics across the country spend the first few hours of their day reviewing page after page of noise, be it false brady episodes, false tachy episodes, and patient symptom events. We are calling patients on a daily basis to send full interrogations to clear the counters. Have we uncovered true events? Absolutely! However, it’s like searching for a needle in a haystack. And when there is a lot of hay, that needle may not be found. The overwhelming amount of unnecessary workload is creating a burden on clinics throughout the country.

Here are a few ideas to decrease the noise:

  1. Doctors, please be thoughtful about device programming. Program the device to detect the reason for the implant. Please don’t turn on every detection because you can.
  2. Educate your patient at implant about the symptom activator and manual downloads. Perhaps set up a weekly manual download to offset the full counter alert.
  3. CRM manufacturers, please think about the end users before pushing out your fabulous new devices. Create best practices for clinics to emulate. Share your knowledge and ideas with us.

Clinics across the country are burdened with information overload and may not have the right training to analyze all of the information. Doctors and nurses are spending less and less real time with patients; they are forced to sift through reams of meaningless data. I have been working diligently with our Remote Care Coordinators (RCCs) at Geneva Health Solutions ( to create the best platform for ILR management. Our RCCs have been trained extensively on how to remove the noise and report the data. We are packaging and delivering only relevant patient data so clinicians can spend time with their patients, rather than with their computer.

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