|NICE Issues Medtech Innovation Briefing Recognizing Medtronic Reveal LINQ in the Detection of Atrial Fibrillation After Stroke of Unknown Cause|
DUBLIN - February 21, 2018 - Today, the United Kingdom's National Institute for Health and Care Excellence (NICE) issued a Medtech Innovation Briefing on the use of the Medtronic Reveal LINQ(TM) insertable cardiac monitor (ICM) with the Medtronic CareLink® Network, highlighting the device's benefits in detecting suspected atrial fibrillation (AF) after a stroke of unknown cause (cryptogenic stroke), which includes cryptogenic transient ischaemic attack (TIA) and embolic stroke of undetermined source (ESUS).1 The NICE briefing also states the potential for downstream savings if Reveal LINQ detects AF, leading to effective treatment and possible stroke prevention.
Cryptogenic stroke patients have a high risk of recurrent strokes and require confirmed AF diagnoses to receive appropriate preventive therapy, such as blood thinners.2 The NICE briefing identifies several exclusive features of Reveal LINQ that help physicians diagnose and monitor AF including:
"People who have suffered a stroke understandably want to know what caused the stroke in the first place," commented Professor Dame Caroline Watkins, professor of Stroke Care and faculty director of Research and Innovation at the University of Central Lancashire. "The Reveal LINQ helps patients and their physicians hone in on the reason behind their stroke, so they can receive appropriate treatment. This is an incredibly important technology, as it provides these people, their families, and their caregivers, a degree of reassurance and reduces the likelihood and fear of recurrent strokes, thereby significantly improving their quality of life."
The NICE briefing also states the Reveal LINQ can result in resource savings as it uses remote monitoring and can be inserted outside the catheterization lab. Physicians insert the device, which is approximately one-third the size of an AAA battery (~1 cc), just beneath the skin through a small incision in the upper left side of the chest. The device communicates wirelessly with a patient's bedside monitor, which uploads device data to the Medtronic CareLink Network.
AF, a condition that often has no symptoms and may occur infrequently, may not be detected by conventional cardiac monitoring techniques such as in-hospital monitoring, electrocardiography (ECG) or traditional ambulatory monitors such as a Holter monitor. Unlike these short-term monitoring methods, the Reveal LINQ ICM continuously detects and wirelessly records abnormal heart rhythms for up to three years.
"We welcome the news that NICE has recognized the importance of a device that helps to detect AF," said Trudie Lobban MBE, founder and trustee of the Arrhythmia Alliance and AF Association. "There are thousands of patients in the UK unknowingly living with a potentially life-threatening and often extremely debilitating condition, because AF remains undiagnosed. Now, with the announcement from NICE, more people will understand and appreciate the benefits and evidence supporting this minimally invasive diagnostic device."
Patients with AF are five times more likely to have a stroke due to blood clots that may form in the heart and make their way to the brain.3 Undiagnosed AF is believed to be responsible for a significant portion of the 30,000 cryptogenic strokes that occur each year in the United Kingdom.4
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About Reveal LINQ Insertable Cardiac Monitor System
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1 NICE Medtech Innovation Briefing
2 NICE CG 180 Atrial Fibrillation: Management https://www.nice.org.uk/guidance/cg180
3 Wolf PA, et al. Stroke. 1991; 22: 983-988.
4 According to Health Episodes Statistics in 2015-2016, the hospital admission reports were 112,101 hospital admissions for ischemic stroke. The cause remains unexplained after routine evaluation in 20 to 40 percent of those cases (Grau AJ et al 2001 and Adams HP 1993), resulting in the classification, by exclusion, of 33,630 cryptogenic or embolic stroke of undetermined source in 2015-2016.
5 Medtech innovation briefings: https://www.nice.org.uk/about/what-we-do/our-programmes/nice-advice/medtech-innovation-briefings Last accessed January 2018.