Evolution of Implantable Cardiac Monitors: A Comparison of Reveal XT and LINQ Patient Selection, Arrhythmia Detection, and Clinical Outcomes

ABSTRACT Implantable cardiac monitors (ICMs) are useful for long-term arrhythmia monitoring in patients with unexplained symptoms. Temporal trends in the use of ICMs in routine clinical practice, along with the clinical indications for use, arrhythmia detection accuracy, and association with clinical outcomes have not been described. We identified all patients who underwent ICM implantation at the Minneapolis Heart Institute® between January 1, 2011, and February 26, 2016, using diagnosis codes for device implantation. From 2011 to 2016, a total of 603 patients with ICM devices were identified and 570 patients were analyzed including 139 Medtronic Reveal XT between 2011 and 2014, and 431 Reveal LINQ between 2014 and 2016. The 3-fold increase in ICM implants was primarily tied to the rise of LINQ monitoring for cryptogenic stroke patients (36% for LINQ vs. 5% for XT; P < 0.001). LINQ patients had fewer complications than XT patients (2.3% vs. 7.9%; P < 0.001). Atrial fibrillation detection accuracy was sim...