Author + information
- Abhishek Sethi,
- Melissa Buescher,
- Ross Garberich,
- Elizabeth Hoffman and
- Jay Sengupta
Background: Implantable cardiac monitors (ICMs) are useful for long-term arrhythmia monitoring in patients with cryptogenic stroke, syncope, or palpitations. Medtronic Reveal XT™ and subsequently Reveal UNO™ ICMs have been implanted at our institution. The LINQ™ device is smaller and simpler to implant, and thus ICM utilization has increased. We compare the arrhythmia detection accuracy and clinical interventions in patients with XT™ and LINQ™ ICMs.
Methods: This was a single-center retrospective analysis. We identified ICM implants from 1/01/2011 to 2/26/2016 by querying electronic medical records for diagnosis codes associated with ICM implantation. Qualifying subjects were monitored for ≥ 3 months. Device interrogations were adjudicated by pacemaker clinic staff to calculate device accuracy. Interventions such as medication changes, ablation procedures, and device implants as a result of ICM detections were recorded.
Results: From 2011-2014, 139 XT™ devices were implanted, and from 2014-2016, 431 LINQ™ devices were implanted at MHI. The LINQ™ population had fewer complications in patients compared to the XT™. Furthermore, the LINQ™ resulted in higher accuracies in arrhythmia detection compared to XT (P<0.001). Thirty percent of patients with ICM implants had at least one intervention. The intervention frequency is similar between the two models (P = 0.163) as is the time to intervention (P = 0.160).
Conclusions: The dramatic increase in ICM implants was primarily tied to the rise of LINQ™ monitoring for cryptogenic stroke patients. Furthermore, LINQ™ model resulted in fewer peri-procedural complications compared to the XT™. We found an increase in accuracy of LINQ™ compared to XT™ detections, however overall intervention frequency and time to intervention remain unchanged. Further analysis of clinic workflow and cost-benefit ratio may help guide the optimal utilization of this new generation ICM.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias and Clinical EP: Devices 4
Abstract Category: 5. Arrhythmias and Clinical EP: Devices
Presentation Number: 1278-079
- 2017 American College of Cardiology Foundation