Patients with atrial fibrillation or suspected atrial fibrillation could soon be monitored via Medtronic’s CareLink platform. This could substantially increase the number of users.

CareLink is a secure online platform that can be used by doctors for cardiac patients who need telemonitoring. Medtronic officially launched CareLink in Europe at the beginning of 2008, after it had been available in the US for two years.

So far, the platform has been exclusively used for patients with implantable defibrillators and for patients with pacemakers. These devices have to be checked every two to three monthes by specialised cardiologists. Telemonitoring makes this far easier, since it helps to avoid unnecessary consultations.

Medtronic has now announced that, by the end of the year, CareLink will also be compatible with the company’s reveal recorders. These are tiny ECG recorders half the size of a matchbox that are implanted subcutaneously.

The devices can detect atrial fibrillation, which is sometimes difficult to diagnose, especially in patients who do not show it continuously.

Until now, using a reveal recorder for the detection of atrial fibrillation was uncomfortable. To readout the information that was recorded, a doctor had to see the patient and sometimes even remove the device. The new generation of the product transmits all relevant data via a centre console or mobile phone to the CareLink platform.

There are two big groups of patients who could benefit from reveal recorders with a telemonitoring function. One group is patients with suspected AF. The second group is patients with known AF who need ECG-monitoring after ablation therapy.

Opening CareLink for these patients could substantially increase the number of users, since AF becomes increasingly prevalent in an ageing population. In Europe alone, there are an estimated ten million people with known or unknown AF.

“At the moment, there are more than 250,000 patients with pacemakers or ICD being telemonitored via CareLink worldwide, the majority of them in the US,” said Medtronic’s chief executive Bill Hawkins recently at a press event in Tolochenaz, Switzerland. Should AF patients join the crowd, this number could easily double or triple.

What remains unclear, at least in most parts of Europe, is the issue of reimbursement. “For patients with ICD or pace makers we do have satisfactory regulations now in Portugal, in Germany, and in the UK”, said Kathy Cargill, the leading health economist at Medtronic. All other Europen countries have not decided yet on how to deal with the new technology.