Key result
The Medtronic Reveal ILR with FullView Software appropriately detected true tachycardia in 63.9% of episodes in a real-world cohort, and demonstrated 99.3% sensitivity for induced VT/VF.
Why the study?
Does the Medtronic Reveal implantable loop recorder accurately detect tachycardia in patients with suspected or induced arrhythmias?
Cohort (n=2,405)
Does the Medtronic Reveal implantable loop recorder accurately detect tachycardia in patients with suspected or induced arrhythmias?
The Medtronic Reveal ILR with FullView Software demonstrates high sensitivity for detecting ventricular arrhythmias, though a significant proportion of detected episodes in real-world use may be inappropriate.
Answers are grounded in this paper and cite their sources.
High sensitivity supports ILR monitoring for VT/VF; leaves open refinement to reduce inappropriate detections.
AIMS: Implantable loop recorders (ILRs) are valuable for diagnosing arrhythmias. We evaluated tachycardia detection performance of the Medtronic Reveal(®) ILR with FullView™ Software. METHODS AND RESULTS: The rate of occurrence of tachycardia detection [supraventricular tachycardia, ventricular tachycardia (VT), and ventricular fibrillation (VF)] and the percentage of appropriately detected tachycardias were determined from all 2190 ILR patients that transmitted to CareLink over a 4-month period (total follow-up = 135.6 patient-years). All 1909 tachycardia episodes were reviewed. Episodes with actual heart rate above the programmed tachycardia detection rate were classified as appropriate. Sensitivity to detect true ventricular arrhythmias was assessed in another group of 215 patients undergoing implantable cardioverter defibrillator (ICD) implant testing. Skin electrodes represented ILR electrodes. Induced VF (404 episodes) and VT (93 episodes) were processed by an emulation of FullView Software. Generalized estimation equation analysis adjusted for multiple episodes per patient. In the CareLink cohort, 68.7% (63.9% adjusted) of detected episodes had tachycardia above the detection rate. Of 1642 episodes detected in the VT zone (12.1 episodes/patient-year), 78.8% (79.0% adjusted) had tachycardia above the detection rate. Of 267 episodes detected in the fast VT zone (1.9 episodes/patient-year), 6.7% (9.4% adjusted) had tachycardia above the detection rate. Twelve true VT/VF episodes were observed in 10 patients. In the ICD patient cohort, 95.9% (96.5% adjusted) of induced VT/VF segments were correctly detected at nominal rate cutoffs. When VT detection was set to 130 b.p.m. (to include the slowest VT), 99.0% (99.3% adjusted) were correctly detected. CONCLUSION: The majority (63.9%) of detected tachycardias contained true tachycardia. Sensitivity to detect induced VT/VF was 99.3%.
No takes yet. Share an insight, caveat, or question.
VOLOSIN et al. (2013) conducted a cohort in Arrhythmias (n=2,405). Medtronic Reveal ILR with FullView Software was evaluated on Percentage of appropriately detected tachycardias (actual heart rate above programmed rate). The Medtronic Reveal ILR with FullView Software appropriately detected true tachycardia in 63.9% of episodes in a real-world cohort, and demonstrated 99.3% sensitivity for induced VT/VF.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: