Abstract
IntroductionReveal LinQ is a novel, wireless implantable monitor which has revolutionized arrhythmia monitoring. There is no data on the rate of inappropriate detections with transmissions and subsequent clinical and work flow impact in real world.HypothesisInappropriate transmissions from implantable loop recorder are common in daily practice.MethodsWe retrospectively reviewed all the wireless transmissions of all consecutive patients who underwent a Reveal LINQ implantation at our center.ResultsA total of 233 patients were included in the study with a mean age of 60 ±16.5 years. 102 (44%) were males. The primary indications were syncope (37.3%), palpitations (24%) and AF management (18%). Patient’s detections and transmissions were tailored to their indications using a standard, rigorously designed protocol. A total of 3440 CareLink transmissions occurred during the 8 ±4 months of follow up (mean of 15 transmissions per patient) which consisted of routine, symptoms triggered, and device activated transmissions. 70 (30%) patients had inappropriate detections and subsequent transmissions during our study duration. Of these, 35 (50%) patients had undersensing, 20 (29%) had oversensing due to noise, 5 (7%) had PAC reported as AF, 2 (3%) had PVC reported as AF, and 7 (10%) had miscellaneous reasons. There were no clinical predictors (including high BMI) for inappropriate detections. These inappropriate transmissions led to 55 office visits amounting to 1 inappropriate office visit for every 4.2 patients who had a LinQ implanted.ConclusionsInappropriate transmissions are common (in 30% patients) and leads to significant burden on device clinic resources. Efforts should be directed at improving sensing accuracy and reprogramming transmission thresholds.