{"id":"78c17ee26929","type":"article","url":"https://hartvaat.nl/2019/04/23/implanteerbaar-cardiaal-alertsysteem-voor-vroege-herkenning-van-stemi/","title":"Implanteerbaar cardiaal alertsysteem voor vroege herkenning van STEMI","title_en":"Implantable Cardiac Alert System for Early Recognition of ST-Segment Elevation Myocardial Infarction.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["icd-implantatie","stemi"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2019.01.014","source_url":"https://doi.org/10.1016/j.jacc.2019.01.014","authors":["C Michael Gibson","David Holmes","Ghiath Mikdadi","Dale Presser","David Wohns","Megan K Yee","Andrew Kaplan","Allen Ciuffo","Arthur L Eberly","Bruce Iteld","Mitchell W Krucoff"],"significance":6,"published":"2019-04-23","source_date":"2019-04-23","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/peripartum-cardiomyopathie/"],"congress":"","summary_en":"This study evaluated an implantable cardiac alert system for early STEMI recognition, testing whether continuous ECG monitoring with automated alerts can reduce the time to treatment in acute coronary syndromes.","created":"2026-07-03T10:27:53Z","updated":"2026-07-03T13:27:05Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar een implanteerbaar cardiaal alertsysteem voor vroege herkenning van STEMI. Technologische innovatie voor snellere behandeling.","abstract_original":"BACKGROUND: Symptoms remain a poor prompt for acute coronary syndromes (ACS). Timely restoration of perfusion in ST-segment elevation myocardial infarction is associated with improved left ventricular function and survival. OBJECTIVES: This report details the results of ALERTS (AngelMed for Early Recognition and Treatment of STEMI), a multicenter, randomized trial of an implantable cardiac monitor that alerts patients with rapidly progressive ST-segment deviation. METHODS: High-risk ACS subjects (N = 907) were randomized to a control (alarms deactivated) or treatment group for 6 months, after which alarms were activated in all subjects. The primary safety endpoint was absence of system-related complications (>90%). The composite primary efficacy endpoint was cardiac/unexplained death, new Q-wave myocardial infarction, or detection to presentation time >2 h. RESULTS: Safety was met with 96.7% freedom from system-related complications (n = 30). The efficacy endpoint for a confirmed occlusive event within 7 days was not significantly reduced in the treatment compared with control group (16 of 423 [3.8%] vs. 21 of 428 [4.9%], posterior probability = 0.786). Within a 90-day window, alarms significantly decreased detection to arrival time at a medical facility (51 min vs. 30.6 h; Pr [pt < pc] >0.999). In an expanded analysis using data after the randomized period, positive predictive value was higher (25.8% vs. 18.2%) and false positive rate significantly lower in the ALARMS ON group (0.164 vs. 0.678 false positives per patient-year; p < 0.001). CONCLUSIONS: The implantable cardiac system detects early ST-segment deviation and alerts patients of a potential occlusive event. Although the trial did not meet its pre-specified primary efficacy endpoint, results suggest that the device may be beneficial among high-risk subjects in potentially identifying asymptomatic events. (AngelMed for Early Recognition and Treatment of STEMI [ALERTS]; NCT00781118)."}