BACKGROUND: Implantable loop recorder (ILR) is preferred strategy for prolonged rhythm monitoring. OBJECTIVE: The purpose of this study was to report the incidence and causes of false-positive (FP) diagnoses during remote monitoring with ILR. METHODS: During a 4-week study period, all consecutive remote transmissions in patients with ILR (Reveal LINQ, Medtronic) implanted for atrial fibrillation (AF) surveillance, cryptogenic stroke (CS), and syncope were reviewed. A nurse specializing in device management and an electrophysiologist adjudicated all transmissions. Primary endpoint of the study was incidence of FP in patients with AF, CS, and syncope. RESULTS: A total of 695 remote transmissions (scheduled downloads: 414; Alerts: 281) sent from 559 patients were adjudicated. The majority of patients had ILR for AF surveillance (n = 321), followed by CS (n =168) and syncope (n = 70) with nominal programming for rhythm diagnosis. Incidence of FP transmissions during the study period was 46%, 86%, and 71% in patients with AF, CS, and syncope, respectively. Incidence of FP transmissions was higher in patients with CS and syncope than in patients with AF (P <.001). For scheduled transmissions, primary causes of FP were signal dropout and undersensing; for alert transmissions, primary reasons for FP were premature atrial and ventricular ectopy. CONCLUSION: Incidence of FP during remote monitoring with nominal settings on this ILR was substantial, ranging from 46% to 86% depending on the indication for implantation. Adjudication of these transmissions required a considerable time commitment from electrophysiologists and device clinic personnel but would be required to avoid misdiagnosis and potential errors in clinical management.
BACKGROUND: Implantable loop recorder (ILR) is preferred strategy for prolonged rhythm monitoring. OBJECTIVE: The purpose of this study was to report the incidence and causes of false-positive (FP) diagnoses during remote monitoring with ILR. METHODS: During a 4-week study period, all consecutive remote transmissions in patients with ILR (Reveal LINQ, Medtronic) implanted for atrial fibrillation (AF) surveillance, cryptogenic stroke (CS), and syncope were reviewed. A nurse specializing in device management and an electrophysiologist adjudicated all transmissions. Primary endpoint of the study was incidence of FP in patients with AF, CS, and syncope. RESULTS: A total of 695 remote transmissions (scheduled downloads: 414; Alerts: 281) sent from 559 patients were adjudicated. The majority of patients had ILR for AF surveillance (n = 321), followed by CS (n =168) and syncope (n = 70) with nominal programming for rhythm diagnosis. Incidence of FP transmissions during the study period was 46%, 86%, and 71% in patients with AF, CS, and syncope, respectively. Incidence of FP transmissions was higher in patients with CS and syncope than in patients with AF (P <.001). For scheduled transmissions, primary causes of FP were signal dropout and undersensing; for alert transmissions, primary reasons for FP were premature atrial and ventricular ectopy. CONCLUSION: Incidence of FP during remote monitoring with nominal settings on this ILR was substantial, ranging from 46% to 86% depending on the indication for implantation. Adjudication of these transmissions required a considerable time commitment from electrophysiologists and device clinic personnel but would be required to avoid misdiagnosis and potential errors in clinical management.
Authors: Slaven Pikija; Cornelia Rösler; Ursula Leitner; Thomas Zellner; Nele Bubel; Bernhard Ganser; Constantin Hecker; Johannes Sebastian Mutzenbach Journal: Front Neurol Date: 2022-01-28 Impact factor: 4.003
Authors: John Ip; Brian Jaffe; Mark Castellani; Ali Sheikh; Carson Castellani; Randy Ip Journal: Pacing Clin Electrophysiol Date: 2020-10-03 Impact factor: 1.976
Authors: Dhiraj Gupta; Johan Vijgen; Tom De Potter; Daniel Scherr; Hugo Van Herendael; Sebastien Knecht; Richard Kobza; Benjamin Berte; Niels Sandgaard; Jean-Paul Albenque; Gábor Széplaki; Yorick Stevenhagen; Philippe Taghji; Matt Wright; Mattias Duytschaever Journal: Heart Date: 2021-05-05 Impact factor: 5.994
Authors: Elham Bidar; Stef Zeemering; Martijn Gilbers; Aaron Isaacs; Sander Verheule; Matthias D Zink; Bart Maesen; Sander Bramer; Michal Kawczynski; Isabelle C Van Gelder; Harry J G M Crijns; Jos G Maessen; Ulrich Schotten Journal: Europace Date: 2021-12-07 Impact factor: 5.486