Background: An increasing number of patients are receiving long term cardiac monitoring with implantable devices. The Reveal LINQ insertable cardiac monitor (ICM) (Medtronic, Minneapolis, MN, U.S.A.), is a miniaturized, subcutaneous, cardiac monitoring device which is extensively used in the diagnosis and management of arrhythmias.
Objective: To study the incidence of inappropriate (false-positive (FP)) diagnoses of pause during remote cardiac monitoring with the Reveal LINQ ICM.
Methods: In this non-randomized retrospective study, all clinic patients with a Reveal LINQ ICM implanted between March 2014 and December 2019 were included. The record of the last reported pause for each patient was reviewed.
Results: Of 242 consecutive patients, 84 patients (average age= 63.4, Female = 38 (45%)) had at least one report of pause. There were 41 true pause episodes and 43 inappropriate pause detections. The device accuracy for detecting a true pause was 48 %. The percentage of FP reported pauses was 52%. The incidence of FP was similar in males and females (Male=50%, Female= 52%). The highest FP rate was observed in patients with palpitations (62%). Our findings based on the reason for monitoring are summarized in Table 1.
Conclusion: There is a high rate of inappropriate pause detection by the Reveal LINQ ICM requiring tracing examination by an expert. More robust algorithms need to be developed for the Reveal LINQ ICM to reduce the rate of FP.