Placement of Reveal LINQ Device in the Left Anterior Axillary Position
- 32 Downloads
Implantable loop recorders (ILR) are utilized for long-term rhythm monitoring. Typical placement of the Medtronic Reveal LINQ along the left parasternal border may compromise the quality and/or feasibility of future imaging studies. We sought to evaluate the utility of placing an ILR in the left anterior axillary position and the impact on the quality of cardiac imaging. We reviewed patients from May 2017 to June 2018 who had placement of a Reveal LINQ device in the left anterior axillary position. Demographic, procedural, and clinical data were collected via retrospective review. Cardiac magnetic resonance imaging (MRI) studies were reviewed for image quality after ILR placement. Eight patients met inclusion criteria for this study (median age 6 years, 50% female). Six patients (75%) had an ILR placed in the operating room, while all others were placed in the electrophysiology lab. All patients demonstrated acceptable R waves for diagnostic evaluation (median = 0.85 mV, range 0.24–1.7 mV). Cardiac MRI was obtained in 7 patients following ILR placement with diagnostic image quality and no adverse events. One device was explanted 28 days after placement due to concern for possible infection. No other devices required removal or revision (median follow up duration 11 months, IQR 8–13.5). ILR placement in the left anterior axillary position can record adequate signals in pediatric patients. In addition, axillary ILR device position may allow for completion of cardiac imaging, particularly cardiac MRI, without significant artifacts which is critical for patients with congenital heart disease.
KeywordsImplantable loop recorder Electrophysiology Congenital heart disease Cardiac imaging MRI
Implantable loop recorder
Magnetic resonance imaging
Institutional review board
Compliance with Ethical Standards
Conflicts of interest
The authors declare that they have no conflict of interest.
- 9.Wiles BM, Illingworth CA, Couzins ML, Roberts PR, Harden SP (2018) A tertiary centre experience of thoracic CT and cardiac MRI scanning in the presence of a Reveal LINQ insertable cardiac monitoring system: a case series review of artefact, patient safety and data preservation. Br J Radiol 91(1086):20170615PubMedPubMedCentralGoogle Scholar
- 10.Shen WK, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD et al (2017) 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation 136(5):e60–e122PubMedGoogle Scholar
- 13.Gunda S, Reddy YM, Pillarisetti J, Koripalli S, Jeffery C, Swope J et al (2015) 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! Int J Cardiol 191:58–63CrossRefGoogle Scholar