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  • Title: The Guardian: an implantable system for chronic ambulatory monitoring of acute myocardial infarction.
    Author: Hopenfeld B, John MS, Fischell DR, Medeiros P, Guimarães HP, Piegas LS.
    Journal: J Electrocardiol; 2009; 42(6):481-6. PubMed ID: 19631947.
    Abstract:
    The AngelMed Guardian is an implantable medical device that records cardiac data and detects ischemic events using a standard pacemaker intracardiac lead positioned in the right ventricular apex. The Guardian has been implanted in 55 people in the United States and Brazil and is currently undergoing a Food and Drug Administration phase 2 pivotal trial in the United States. The Guardian detects acute ischemic events by analyzing ST-segment shifts. The ST-segment shifts are calculated as the difference between the ST deviation of a current 10-second electrogram window and a baseline ST deviation value. If the ST-segment shift is greater than a heart rate-dependent programmable threshold, then the device generates an emergency alert signal. Results thus far have demonstrated that (i) the intracardiac electrogram is relatively noise-free and (ii) the ST-shift technique used by the Guardian is effective for detecting acute ischemic events.
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