97-03: Two generations of implantable loop recorders in clinical practice in low risk patients with syncope and pre-syncope of uncertain origin

Background: The purpose of our study was to two assess differences in clinical routine implantation of two generations of implantable loop recorders (ILR; Reveal XT and Reveal LINQ, Medtronic, Minneapolis, MN, USA), and to analyze the incidence of active CIED implantation in patients following loop recorder implantation due syncope and pre-syncope of uncertain origin. Methods: All patients with syncope or pre-syncope of uncertain origin implanted with Reveal XT or LINQ between Jan 2012 and Dec 2015 were included in this retrospective study. Statistical analyses were performed using Man-Whitney U Test for comparison of continuous variables (e.g. implantation and follow-up characteristics), chi2 test for comparison of categorical variables. Survival without implantation of an active CIED was compared with the Log rank test. A p < 0.05 was considered significant. Results: During the observational period (448 ± 409 days) 177 patients (mean age 66 ± 16, female 86 [49%], syncope 154 [87%], pre-syncope 23 [13%]) were implanted with Reveal ILR (XT: 54 (31%); LINQ 123 (70%). All XT were implanted in the cath lab, LINQ in the cath labs anteroom. The time cath lab nurses spend with the patient decreased significantly (XT: median 46 min; LINQ median 16 min; p < 0.001) as the total implant duration did (XT: median 10 min; LINQ median 2 min; p < 0.001). The incidence of active CIED implantation in follow-up was statistically not different between patients with different ILRs (XT: 15 [28%]; LINQ 25 [20%]), and between patients with different ILR indications (syncope: 35 [23%]; pre-syncope 5 [22%]). Conclusion: The utility of Reveal LINQ saves resources. Patients with ILR indication of pre-syncope have the same incidence of active CIED implantation in follow-up as syncope patients.