# Implanteerbaar cardiaal alertsysteem voor vroege herkenning van STEMI

*geplaatst 2019-04-23 · Algemeen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2019.01.014 · https://hartvaat.nl/2019/04/23/implanteerbaar-cardiaal-alertsysteem-voor-vroege-herkenning-van-stemi/*

Studie naar een implanteerbaar cardiaal alertsysteem voor vroege herkenning van STEMI. Technologische innovatie voor snellere behandeling.

## English: Implantable Cardiac Alert System for Early Recognition of ST-Segment Elevation Myocardial Infarction.

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.

## Abstract (original, from the publication)

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).

Auteurs: 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

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2019.01.014. Bijgewerkt 2026-07-03T13:27:05Z. 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.