PO-03-055 INCIDENCE OF INAPPROPRIATE PAUSE DETECTION WITH REMOTE CARDIAC MONITORING BY INSERTABLE CARDIAC MONITOR, A REAL-WORLD STUDY

Abstract

An increasing number of people receive long-term cardiac monitoring with implantable devices due to the growing prevalence of cardiac arrhythmias. The LINQ II is Medtronic’s latest generation insertable cardiac monitor (ICM) (Medtronic, Minneapolis, MN, U.S.A.) Compared to its previous generation, Reveal LINQ ICM, the LINQ II ICM employs artificial intelligence (AI) to reduce the false positive (FP) detection of pause. We previously showed that the rate of FP pause among our patients with Reveal LINQ ICM was 52%, but some researchers showed this rate could be as high as 76%. To detect the incidence of inappropriate (FP) diagnoses of pause during remote cardiac monitoring with the LINQ II ICM. This is a non-randomized retrospective study. All our clinic patients with LINQ II ICM between May 2021 and November 2022 were included. We excluded the patients with incomplete data. The record of all pauses for each patient was reviewed. Of 73 consecutive patients (average age 64.9, Female = 35 (48%)), 10 patients had at least one report of pause, and the total number of reported pauses was 43 (average 4.3 per patient, min = 1, max = 12). There were 15 true pause episodes and 28 inappropriate pause detections. The device’s accuracy in detecting a true pause was 35%. The rate of reported FP pauses was 65%. Five patients had at least one episode of true pause. The specificity of LINQ II ICM to find patients with pause was 50%. Despite using AI, there is a high rate of inappropriate pause detection by the LINQ II ICM, and tracing examination by an expert is essential to confirm the validity of the device report. AI didn’t improve the accuracy of pause detection in our patients. More robust algorithms are required to be developed for the LINQ II ICM to reduce the rate of FP.