Abstract 12056: Incidence of Actionable Events on Implantable Cardiac Monitors: A Prospective Study Comparing Reveal LINQ TM and Confirm Rx TM Implantable Cardiac Monitors

Abstract

Introduction: Implantable cardiac monitors (ICM) are increasingly being used to detect and treat arrhythmias in various clinical settings such as cryptogenic stroke. However, the incidence of actionable events in ICMs is unknown. Hypothesis: Confirm Rx TM has more actionable event detection rate than Reveal LINQ TM Methods: We prospectively studied 411 patients who received Reveal LINQ TM (Medtronic Inc., Dublin, Ireland) or Confirm Rx TM (Abbott, Sylmar, CA) ICM system for diagnosis of actionable arrhythmic events. Actionable arrhythmic events were defined as atrial fibrillation (AF) requiring anticoagulation, pauses requiring pacemaker, and tachycardia requiring ablation or medication changes. All actionable events were adjudicated for accuracy. Results: This study evaluated 411 patients with baseline characteristics of: 52.1% females, an average age of 65.81 years, and an average body mass index of 29.9 kg/m 2 . Reasons for ICM implants were, in descending order: cryptogenic stroke (44.3%), syncope (35%), and palpitations (20.9%). The Reveal LINQ TM was used in 56.4% (n=232) of patients and Confirm Rx TM was used in the other 43.6% (n=179). On univariate analysis, the composite outcome of actionable events were similar in both groups (Reveal LINQ TM 19% vs Confirm Rx TM 19%, p>0.9). The individual actionable event outcome were also similar in both groups: AF (Reveal LINQ TM 11% vs Confirm Rx TM 8.5%, p=0.6), pauses (Reveal LINQ TM 1.3% vs Confirm Rx TM 4.0%, p=0.2), tachycardia (Reveal LINQ TM 6.0% vs Confirm Rx TM 5.6%, p>0.9). However, the time to actionable event or last follow-up was significantly reduced (p<0.001) in the Confirm Rx TM (median 203 days, interquartile range 90-371 days) as compared to Reveal LINQ TM (median 300 days, interquartile range 128-488 days). Conclusions: This study showed that although Reveal LINQ TM and Confirm Rx TM have similar actionable event detection rates, Confirm Rx TM has a shorter duration to diagnose true arrhythmic events. This difference may be due to their intrinsic detection algorithm. Larger studies are required to confirm this finding.