Abstract 17460: Initial Clinical Experience with the Medtronic LinQ Loop Recorder: Concerns about Data Deluge

Introduction: Long-term ECG monitoring is often necessary in patients (pts) with unexplained syncope and suspected or known atrial fibrillation (AF). The recently released Medtronic LinQ loop recorder (ILR) accrues ECG data daily; “alert” conditions are wirelessly transmitted to providers. To date, the frequency and characteristics of these alerts are unknown. Hypothesis: We hypothesized that alerts would occur infrequently, thus allowing for remote management of large numbers of pts. Methods: Consecutive pts implanted with the LinQ were assessed. All alerts were collected and analyzed. Alerts ideally reflect a change within the past 24 hours of monitoring. However, some alerts (once triggered) perpetuate daily until cleared by a patient initiating a manual transmission. Results: Our first 100 LinQ pts (mean age 67.5 years; 51% male) implanted within the first 3 months of market release were assessed. The indications for monitoring included suspected AF (cryptogenic stroke, n=10; history of atrial flutter, n=1), known AF (n=61), and unexplained syncope (n=25). During follow-up, an alert occurred in 63 pts; a similar frequency of alerts occurred in AF and syncope pts (Figure). Once present, 29 (46%) alerts perpetuated daily and required manual transmission to clear. Conclusion: We report the initial clinical experience with the LinQ ILR. We found that alerts occurred frequently, irrespective of indication for monitoring. Once present, alerts were frequently perpetuated due to a major design limitation. A more robust system is needed to triage the data being accrued to prevent unnecessary data deluge.