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Accuracy of arrhythmia detection in implantable cardiac monitors: A prospective randomized clinical trial comparing Reveal LINQ and Confirm Rx
Background Implantable cardiac monitors (ICMs) are increasingly used to detect arrhythmias in various clinical situations. However, the data transmission time and accuracy of detecting cardiac arrhythmias are unclear. Objective The objective of this study was to compare the efficiency of data transm...
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| Published in: | Pacing and clinical electrophysiology 2020-11, Vol.43 (11), p.1344-1350 |
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| container_issue | 11 |
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| container_title | Pacing and clinical electrophysiology |
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| creator | Ip, John Jaffe, Brian Castellani, Mark Sheikh, Ali Castellani, Carson Ip, Randy |
| description | Background
Implantable cardiac monitors (ICMs) are increasingly used to detect arrhythmias in various clinical situations. However, the data transmission time and accuracy of detecting cardiac arrhythmias are unclear.
Objective
The objective of this study was to compare the efficiency of data transmission and arrhythmia detection accuracy of the Reveal LINQ with TruRhythm Detection with the Confirm Rx with SharpSense Technology.
Methods
In this prospective study, 142 patients were randomized 1:1 to receive Reveal LINQ or Confirm Rx ICM system. Arrhythmic events include atrial fibrillation (AF), pauses, and bradycardia. Data transmission time is defined as the time from event occurrence to physician notification. All the arrhythmic events are adjudicated for accuracy.
Results
A total of 3510 events were transmitted in 61 patients over 7.1 ± 3.5 months. The transmission time both for all events (448 ± 271 vs 610 ± 515 minutes, P = .02) and for patient activated triggers (24 ± 103 vs 475 ± 426 minutes, P |
| doi_str_mv | 10.1111/pace.14076 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7756447</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2460168620</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4486-d758cc69859b8a79871ed7bb06ace28984c403818a45f58fc9c8a27c29bc9d243</originalsourceid><addsrcrecordid>eNp9kV1rFDEUhoNY7Fq98QdIwBsRpiYz-fRCWJZaC4sfRa9D5kymmzKTjJmZ1fVH-JubdduiXhhCDpw8vJzzvgg9o-SU5vN6sOBOKSNSPEALyhkpFOX6IVoQymShKqWP0eNxvCaECML4I3RclVpoTtUC_VoCzMnCDscW25Q2u2nTe4sbNzmYfAzY59sPnQ2TrTuHwabGW8B9DH6KaXyDl3hIcRz2-NbhZEMTe__TNRg6HzzYDk_J5xdiP9jkwxW-dFuXG-uLD59xxvEqhtanHl_-eIKOWtuN7ultPUFf3519Wb0v1h_PL1bLdQGMKVE0kisAoRXXtbJSK0ldI-uaiGxFqbRiwEilqLKMt1y1oEHZUkKpa9BNyaoT9PagO8x17xpwYUq2M0PyvU07E603f_8EvzFXcWuk5IIxmQVe3gqk-G1242R6P4Lrsk8uzqMpGeNaEk2rjL74B72Ocwp5vUwJQoUSJcnUqwMF2cwxufZ-GErMPmazj9n8jjnDz_8c_x69yzUD9AB8953b_UfKfFquzg6iN3oMtTw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2460168620</pqid></control><display><type>article</type><title>Accuracy of arrhythmia detection in implantable cardiac monitors: A prospective randomized clinical trial comparing Reveal LINQ and Confirm Rx</title><source>Wiley</source><source>SPORTDiscus with Full Text</source><creator>Ip, John ; Jaffe, Brian ; Castellani, Mark ; Sheikh, Ali ; Castellani, Carson ; Ip, Randy</creator><creatorcontrib>Ip, John ; Jaffe, Brian ; Castellani, Mark ; Sheikh, Ali ; Castellani, Carson ; Ip, Randy</creatorcontrib><description>Background
Implantable cardiac monitors (ICMs) are increasingly used to detect arrhythmias in various clinical situations. However, the data transmission time and accuracy of detecting cardiac arrhythmias are unclear.
Objective
The objective of this study was to compare the efficiency of data transmission and arrhythmia detection accuracy of the Reveal LINQ with TruRhythm Detection with the Confirm Rx with SharpSense Technology.
Methods
In this prospective study, 142 patients were randomized 1:1 to receive Reveal LINQ or Confirm Rx ICM system. Arrhythmic events include atrial fibrillation (AF), pauses, and bradycardia. Data transmission time is defined as the time from event occurrence to physician notification. All the arrhythmic events are adjudicated for accuracy.
Results
A total of 3510 events were transmitted in 61 patients over 7.1 ± 3.5 months. The transmission time both for all events (448 ± 271 vs 610 ± 515 minutes, P = .02) and for patient activated triggers (24 ± 103 vs 475 ± 426 minutes, P < .0001) was significantly shorter in the Confirm Rx group. The total number of events was also higher in the Confirm Rx group (25.5 ± 45.6 vs 0.9 ± 1.1 events per patient‐month, P < .01), which is likely due to event transmission setting differences between the two groups. Kaplan‐Meier analysis showed that the Confirm Rx group detected true arrhythmic episodes sooner with higher percentage of diagnosed patients during 6‐month follow‐up (P = .006). Patient‐averaged true positive detection rates were not statistically significant in the two groups (Reveal LINQ vs Confirm Rx, AF: 52% vs 38%; bradycardia: 67% vs 59%; pause: 24% vs 20%; tachycardia: 81% vs 94%).
Conclusion
Compared to the Reveal LINQ, Confirm Rx has shorter event transmission time, more frequent event detections, shorter duration to diagnose true arrhythmic events, and higher percentage of diagnosed patients. The accuracy of arrhythmia detection in both ICMs remains suboptimal.</description><identifier>ISSN: 0147-8389</identifier><identifier>EISSN: 1540-8159</identifier><identifier>DOI: 10.1111/pace.14076</identifier><identifier>PMID: 32969518</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Accuracy ; Arrhythmia ; atrial fibrillation ; Bradycardia ; Cardiac arrhythmia ; cryptogenic stroke ; Data transmission ; Devices ; Fibrillation ; Heart ; implantable cardiac monitor ; Monitoring systems ; Patients ; remote monitoring ; Statistical analysis ; syncope ; Tachycardia</subject><ispartof>Pacing and clinical electrophysiology, 2020-11, Vol.43 (11), p.1344-1350</ispartof><rights>2020 The Authors. published by Wiley Periodicals LLC</rights><rights>2020 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC.</rights><rights>2020. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4486-d758cc69859b8a79871ed7bb06ace28984c403818a45f58fc9c8a27c29bc9d243</citedby><cites>FETCH-LOGICAL-c4486-d758cc69859b8a79871ed7bb06ace28984c403818a45f58fc9c8a27c29bc9d243</cites><orcidid>0000-0003-4444-3383</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32969518$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ip, John</creatorcontrib><creatorcontrib>Jaffe, Brian</creatorcontrib><creatorcontrib>Castellani, Mark</creatorcontrib><creatorcontrib>Sheikh, Ali</creatorcontrib><creatorcontrib>Castellani, Carson</creatorcontrib><creatorcontrib>Ip, Randy</creatorcontrib><title>Accuracy of arrhythmia detection in implantable cardiac monitors: A prospective randomized clinical trial comparing Reveal LINQ and Confirm Rx</title><title>Pacing and clinical electrophysiology</title><addtitle>Pacing Clin Electrophysiol</addtitle><description>Background
Implantable cardiac monitors (ICMs) are increasingly used to detect arrhythmias in various clinical situations. However, the data transmission time and accuracy of detecting cardiac arrhythmias are unclear.
Objective
The objective of this study was to compare the efficiency of data transmission and arrhythmia detection accuracy of the Reveal LINQ with TruRhythm Detection with the Confirm Rx with SharpSense Technology.
Methods
In this prospective study, 142 patients were randomized 1:1 to receive Reveal LINQ or Confirm Rx ICM system. Arrhythmic events include atrial fibrillation (AF), pauses, and bradycardia. Data transmission time is defined as the time from event occurrence to physician notification. All the arrhythmic events are adjudicated for accuracy.
Results
A total of 3510 events were transmitted in 61 patients over 7.1 ± 3.5 months. The transmission time both for all events (448 ± 271 vs 610 ± 515 minutes, P = .02) and for patient activated triggers (24 ± 103 vs 475 ± 426 minutes, P < .0001) was significantly shorter in the Confirm Rx group. The total number of events was also higher in the Confirm Rx group (25.5 ± 45.6 vs 0.9 ± 1.1 events per patient‐month, P < .01), which is likely due to event transmission setting differences between the two groups. Kaplan‐Meier analysis showed that the Confirm Rx group detected true arrhythmic episodes sooner with higher percentage of diagnosed patients during 6‐month follow‐up (P = .006). Patient‐averaged true positive detection rates were not statistically significant in the two groups (Reveal LINQ vs Confirm Rx, AF: 52% vs 38%; bradycardia: 67% vs 59%; pause: 24% vs 20%; tachycardia: 81% vs 94%).
Conclusion
Compared to the Reveal LINQ, Confirm Rx has shorter event transmission time, more frequent event detections, shorter duration to diagnose true arrhythmic events, and higher percentage of diagnosed patients. The accuracy of arrhythmia detection in both ICMs remains suboptimal.</description><subject>Accuracy</subject><subject>Arrhythmia</subject><subject>atrial fibrillation</subject><subject>Bradycardia</subject><subject>Cardiac arrhythmia</subject><subject>cryptogenic stroke</subject><subject>Data transmission</subject><subject>Devices</subject><subject>Fibrillation</subject><subject>Heart</subject><subject>implantable cardiac monitor</subject><subject>Monitoring systems</subject><subject>Patients</subject><subject>remote monitoring</subject><subject>Statistical analysis</subject><subject>syncope</subject><subject>Tachycardia</subject><issn>0147-8389</issn><issn>1540-8159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp9kV1rFDEUhoNY7Fq98QdIwBsRpiYz-fRCWJZaC4sfRa9D5kymmzKTjJmZ1fVH-JubdduiXhhCDpw8vJzzvgg9o-SU5vN6sOBOKSNSPEALyhkpFOX6IVoQymShKqWP0eNxvCaECML4I3RclVpoTtUC_VoCzMnCDscW25Q2u2nTe4sbNzmYfAzY59sPnQ2TrTuHwabGW8B9DH6KaXyDl3hIcRz2-NbhZEMTe__TNRg6HzzYDk_J5xdiP9jkwxW-dFuXG-uLD59xxvEqhtanHl_-eIKOWtuN7ultPUFf3519Wb0v1h_PL1bLdQGMKVE0kisAoRXXtbJSK0ldI-uaiGxFqbRiwEilqLKMt1y1oEHZUkKpa9BNyaoT9PagO8x17xpwYUq2M0PyvU07E603f_8EvzFXcWuk5IIxmQVe3gqk-G1242R6P4Lrsk8uzqMpGeNaEk2rjL74B72Ocwp5vUwJQoUSJcnUqwMF2cwxufZ-GErMPmazj9n8jjnDz_8c_x69yzUD9AB8953b_UfKfFquzg6iN3oMtTw</recordid><startdate>202011</startdate><enddate>202011</enddate><creator>Ip, John</creator><creator>Jaffe, Brian</creator><creator>Castellani, Mark</creator><creator>Sheikh, Ali</creator><creator>Castellani, Carson</creator><creator>Ip, Randy</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4444-3383</orcidid></search><sort><creationdate>202011</creationdate><title>Accuracy of arrhythmia detection in implantable cardiac monitors: A prospective randomized clinical trial comparing Reveal LINQ and Confirm Rx</title><author>Ip, John ; Jaffe, Brian ; Castellani, Mark ; Sheikh, Ali ; Castellani, Carson ; Ip, Randy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4486-d758cc69859b8a79871ed7bb06ace28984c403818a45f58fc9c8a27c29bc9d243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Accuracy</topic><topic>Arrhythmia</topic><topic>atrial fibrillation</topic><topic>Bradycardia</topic><topic>Cardiac arrhythmia</topic><topic>cryptogenic stroke</topic><topic>Data transmission</topic><topic>Devices</topic><topic>Fibrillation</topic><topic>Heart</topic><topic>implantable cardiac monitor</topic><topic>Monitoring systems</topic><topic>Patients</topic><topic>remote monitoring</topic><topic>Statistical analysis</topic><topic>syncope</topic><topic>Tachycardia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ip, John</creatorcontrib><creatorcontrib>Jaffe, Brian</creatorcontrib><creatorcontrib>Castellani, Mark</creatorcontrib><creatorcontrib>Sheikh, Ali</creatorcontrib><creatorcontrib>Castellani, Carson</creatorcontrib><creatorcontrib>Ip, Randy</creatorcontrib><collection>Wiley-Blackwell Open Access Titles (Open Access)</collection><collection>Wiley Free Archive</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pacing and clinical electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ip, John</au><au>Jaffe, Brian</au><au>Castellani, Mark</au><au>Sheikh, Ali</au><au>Castellani, Carson</au><au>Ip, Randy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accuracy of arrhythmia detection in implantable cardiac monitors: A prospective randomized clinical trial comparing Reveal LINQ and Confirm Rx</atitle><jtitle>Pacing and clinical electrophysiology</jtitle><addtitle>Pacing Clin Electrophysiol</addtitle><date>2020-11</date><risdate>2020</risdate><volume>43</volume><issue>11</issue><spage>1344</spage><epage>1350</epage><pages>1344-1350</pages><issn>0147-8389</issn><eissn>1540-8159</eissn><abstract>Background
Implantable cardiac monitors (ICMs) are increasingly used to detect arrhythmias in various clinical situations. However, the data transmission time and accuracy of detecting cardiac arrhythmias are unclear.
Objective
The objective of this study was to compare the efficiency of data transmission and arrhythmia detection accuracy of the Reveal LINQ with TruRhythm Detection with the Confirm Rx with SharpSense Technology.
Methods
In this prospective study, 142 patients were randomized 1:1 to receive Reveal LINQ or Confirm Rx ICM system. Arrhythmic events include atrial fibrillation (AF), pauses, and bradycardia. Data transmission time is defined as the time from event occurrence to physician notification. All the arrhythmic events are adjudicated for accuracy.
Results
A total of 3510 events were transmitted in 61 patients over 7.1 ± 3.5 months. The transmission time both for all events (448 ± 271 vs 610 ± 515 minutes, P = .02) and for patient activated triggers (24 ± 103 vs 475 ± 426 minutes, P < .0001) was significantly shorter in the Confirm Rx group. The total number of events was also higher in the Confirm Rx group (25.5 ± 45.6 vs 0.9 ± 1.1 events per patient‐month, P < .01), which is likely due to event transmission setting differences between the two groups. Kaplan‐Meier analysis showed that the Confirm Rx group detected true arrhythmic episodes sooner with higher percentage of diagnosed patients during 6‐month follow‐up (P = .006). Patient‐averaged true positive detection rates were not statistically significant in the two groups (Reveal LINQ vs Confirm Rx, AF: 52% vs 38%; bradycardia: 67% vs 59%; pause: 24% vs 20%; tachycardia: 81% vs 94%).
Conclusion
Compared to the Reveal LINQ, Confirm Rx has shorter event transmission time, more frequent event detections, shorter duration to diagnose true arrhythmic events, and higher percentage of diagnosed patients. The accuracy of arrhythmia detection in both ICMs remains suboptimal.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32969518</pmid><doi>10.1111/pace.14076</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-4444-3383</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Pacing and clinical electrophysiology, 2020-11, Vol.43 (11), p.1344-1350 |
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| source | Wiley; SPORTDiscus with Full Text |
| subjects | Accuracy Arrhythmia atrial fibrillation Bradycardia Cardiac arrhythmia cryptogenic stroke Data transmission Devices Fibrillation Heart implantable cardiac monitor Monitoring systems Patients remote monitoring Statistical analysis syncope Tachycardia |
| title | Accuracy of arrhythmia detection in implantable cardiac monitors: A prospective randomized clinical trial comparing Reveal LINQ and Confirm Rx |
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