title: Initial real world experience with a novel insertable (Reveal LinQ(@Medtronic)) compared to the conventional (Reveal XT(@Medtronic)) implantable loop recorder at a tertiary care center - Points to ponder!
abstract: BACKGROUND
  Limited data is available regarding the novel Reveal LinQ (LinQ) which is a new generation implantable loop recorders (ILRs).
  
  
  METHODS
  We performed a prospective, observational study of all consecutive patients undergoing conventional (Reveal XT; XT) and LinQ devices at our institution between January 2012 and December 2014.
  
  
  RESULTS
  A total of 217 patients underwent ILR implantation. XT was implanted in 105 and LinQ in 112 patients. There were no significant differences in baseline characteristics between the two groups. LinQ implantation using the manufacturer's technique termed, "manufacturer's method" group had significantly higher incidence of pocket infection compared to XT (6/50, 12% vs 3/105, 3%, p=0.032). With modifications to the LinQ implantation technique (using a conventional scalpel and placing a suture when needed to the incision) termed "modified method" group, the rate of infection has decreased significantly compared to "manufacturer's method group" (0/62, 0% vs 6/50, 12%, p=0.004) (Table 3). In multivariate regression analysis, the only independent predictors of infection were younger age (OR 0.95; p=0.04), insertion of LinQ device (OR 30.02; p=0.006) and procedure time (OR 1.07; p=0.03).
  
  
  CONCLUSIONS
  In our single-center, prospective, observational study we found that with the current implantable techniques, the novel insertable LinQ device is associated with increased risk of complications.
authors.affiliation: University of Kansas Hospital, Kansas City, KS, United States.
authors.forename: Sampath
authors.initials: S
authors.lastname: Gunda
authors.affiliation: University of Kansas Hospital, Kansas City, KS, United States.
authors.forename: Yeruva Madhu
authors.initials: YM
authors.lastname: Reddy
authors.affiliation: University of Kansas Hospital, Kansas City, KS, United States.
authors.forename: Jayasree
authors.initials: J
authors.lastname: Pillarisetti
authors.affiliation: University of Kansas Hospital, Kansas City, KS, United States.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Koripalli
authors.affiliation: University of Kansas Hospital, Kansas City, KS, United States.
authors.forename: Courtney
authors.initials: C
authors.lastname: Jeffery
authors.affiliation: University of Kansas Hospital, Kansas City, KS, United States.
authors.forename: Jeanine
authors.initials: J
authors.lastname: Swope
authors.affiliation: University of Kansas Hospital, Kansas City, KS, United States.
authors.forename: Donita
authors.initials: D
authors.lastname: Atkins
authors.affiliation: University of Kansas Hospital, Kansas City, KS, United States.
authors.forename: Sudharani
authors.initials: S
authors.lastname: Bommana
authors.affiliation: University of Kansas Hospital, Kansas City, KS, United States.
authors.forename: Martin P
authors.initials: MP
authors.lastname: Emert
authors.affiliation: University of Kansas Hospital, Kansas City, KS, United States.
authors.forename: Rhea
authors.initials: R
authors.lastname: Pimentel
authors.affiliation: University of Kansas Hospital, Kansas City, KS, United States.
authors.forename: Raghuveer
authors.initials: R
authors.lastname: Dendi
authors.affiliation: University of Kansas Hospital, Kansas City, KS, United States.
authors.forename: Loren D
authors.initials: LD
authors.lastname: Berenbom
authors.affiliation: Texas Cardiac Arrhythmia Institute, Austin, TX, United States.
authors.forename: Luigi
authors.initials: L
authors.lastname: DiBiase
authors.affiliation: Texas Cardiac Arrhythmia Institute, Austin, TX, United States.
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
authors.affiliation: University of Kansas Hospital, Kansas City, KS, United States. Electronic address: dlakkireddy@kumc.edu.
authors.forename: Dhanunjaya
authors.initials: D
authors.lastname: Lakkireddy
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000628:therapy; D017147:Defibrillators, Implantable / Q000009:adverse effects* / Q000382:microbiology; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D013575:Syncope / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D062606:Tertiary Care Centers
keywords: Cardiac implantable electronic devices; Device infection; Implantable loop recorders