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This study is to determine, through continuous monitoring with the Reveal implantable cardiac monitor (ICM), the incidence of atrial fibrillation (AF) in patients suspected to be at high risk for having AF and to understand how physicians manage these patients after AF has been detected. This study will also seek to identify what patient characteristics are most predictive of developing AF.
Time to first Atrial Fibrillation lasting six or more minutes. [ Time Frame: Implant to 18 month follow-up visit ]
Each arrhythmic episode detected by the patient's Reveal device will be reviewed to determine if it is 1) an actual atrial fibrillation episode, and (2) are at least 6 minutes in duration. The time to the first such episode in which both criteria are met will be the endpoint for each patient.
Secondary Outcome Measures
Predictors of Atrial Fibrillation [ Time Frame: Time from implant to date of last stored available implanted device data (maximum of 30 months) ]
Atrial Fibrillation will be defined as in the primary outcome. Baseline characteristics including demographics, medical history, and biomarkers at enrollment will be tested for their association with a patient's risk of developing atrial fibrillation.
Actions taken in response to awareness of atrial fibrillation [ Time Frame: Time from first identified episode of atrial fibrillation to study exit (maximum of 30 months) ]
Clinical actions taken in response to clinician awareness of a patient's atrial fibrillation onset or progression will be summarized
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study:
18 Years and older (Adult, Senior)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Patient meets the approved indications to receive the Reveal ICM
Patient is suspected, based on symptomatology and/or demographics, of having atrial fibrillation or at high risk of having AF, as determined by the clinical investigator
Patient has a CHADS2 score ≥ 3 OR has a CHADS2 score = 2 WITH at least one of the following documented: renal impairment (GFR 30-60 ml/min), sleep apnea, coronary artery disease, or chronic obstructive pulmonary disease. Note: stroke/TIA criterion as part of the CHADS2 score for this trial is limited to either an ischemic stroke or TIA, which occurred MORE THAN one year prior to enrollment.
Patient is 18 years of age or older
Patient has a life expectancy of 18 months or more
Patient, or legally authorized representative, is willing to sign and date the consent form
Patient is willing and able to be remotely monitored (i.e., eligible for enrollment into the Medtronic CareLink Network)
Patient has a documented history of AF or atrial flutter
Patient had an ischemic stroke or TIA within past year prior to enrollment
Patient has a history of a hemorrhagic stroke
Patient is currently implanted with an IPG, ICD, CRT-P, or CRT-D device
NYHA Class IV Heart Failure patient
Patient had heart surgery within previous 90 days prior to enrollment
Patient had an MI within the previous 90 days prior to enrollment
Patient is taking chronic immuno-suppressant therapy
Patient is taking an anti-arrhythmic drug
Patient is contraindicated for long term anticoagulation medication
Patient is taking a long-term anticoagulation medication
Any concomitant condition which, in the opinion of the investigator, would not allow safe participation in the study (e.g., drug addiction, alcohol abuse, emotional / psychological diagnosis)
Patient is enrolled in another study that could confound the results of this study, without documented pre-approval from Medtronic study manager
Patient has a creatinine clearance <30 ml/min or is on dialysis