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Indications, Safety, and Warnings

Indications, safety, and warnings
Cardiac diagnostics and monitoring systems

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Brief statement for Medtronic LINQ II insertable cardiac monitor system (ICM) and remote monitoring

Indications
The LINQ II ICM is an insertable automatically-activated and patient-activated monitoring system that records subcutaneous ECG and is indicated in adult patients, and in pediatric patients who are at least 2 years old, in the following cases:

  • patients with clinical syndromes or situations at increased risk of cardiac arrhythmias
  • patients who experience transient symptoms such as dizziness, palpitation, syncope, and chest pain that may suggest a cardiac arrhythmia

Contraindications
There are no known contraindications for the insertion of the LINQ II ICM or its accessories. However, the patient’s particular medical condition may dictate whether or not a subcutaneous, chronically inserted device can be tolerated.

Warnings and Precautions
Patients with the LINQ II ICM should avoid sources of diathermy, high sources of radiation, electrosurgical cautery, external defibrillation, lithotripsy, therapeutic ultrasound and radiofrequency ablation to avoid electrical reset of the device, and/or inappropriate sensing as described in the Medical procedure and EMI Warnings, Precautions and Guidance Manual. MRI scans should be performed only in a specified MR environment under specified conditions as described in the LINQ II MRI Technical Manual.

Wireless accessories available for use with LINQ II may experience connectivity or performance issues. See product manuals for details and troubleshooting instructions.

Potential Adverse Events
Potential adverse events from the LINQ II ICM include, but are not limited to, device rejection phenomena (including local tissue reaction), device migration, infection, and erosion through the skin.

There are no known adverse events associated with the use of any LINQ II ICM wireless accessory.

See the device manuals for detailed information regarding the implant procedure, indications/intended use, contraindications, warnings, precautions, and potential complications/adverse events. For further information, please call Medtronic at 800-328-2518 (Technical Services), 800-551-5544 (Patient Services), and/or consult Medtronic’s website at www.medtronic.com.

Caution: Federal law (USA) restricts prescription devices to sale by or on the order of a physician.

Reveal LINQ insertable cardiac monitor, Reveal LINQ mobile manager system, and patient assistant

Indications: The Reveal LINQ™ insertable cardiac monitor (ICM) is an implantable patient-activated and automatically activated monitoring system that records subcutaneous ECG and is indicated in the following cases:

  • Patients with clinical syndromes or situations at increased risk of cardiac arrhythmias
  • Patients who experience transient symptoms such as dizziness, palpitation, syncope, and chest pain, that may suggest a cardiac arrhythmia

The device has not been tested specifically for pediatric use.

Reveal LINQ Mobile Manager System: The Reveal LINQ Mobile Manager app is intended for programming and interrogating the Reveal LINQ ICM LNQ11. The Medtronic patient connector is a portable electronic device using low frequency inductive telemetry to communicate with the Reveal LINQ ICM. The patient connector uses Bluetooth® technology to transmit implantable heart device data to the Reveal LINQ Mobile Manager app for further processing. The patient connector is intended to be used by healthcare personnel only in a clinical or hospital environment.

Patient Assistant: The Patient Assistant is intended for unsupervised patient use away from a hospital or clinic. The Patient Assistant activates the data management feature in the Reveal™ insertable cardiac monitor to initiate recording of cardiac event data in the implanted device memory.

Contraindications: There are no known contraindications for the implant of the Reveal LINQ ICM or for the Reveal LINQ Mobile Manager system. However, the patient’s particular medical condition may dictate whether or not a subcutaneous, chronically implanted device can be tolerated.

Reveal LINQ Insertable Cardiac Monitor

Warnings/Precautions: Patients with the Reveal LINQ ICM should avoid sources of diathermy, high sources of radiation, electrosurgical cautery, external defibrillation, lithotripsy, therapeutic ultrasound, and radiofrequency ablation to avoid electrical reset of the device, and/or inappropriate sensing as described in the medical procedure and EMI precautions manual. MRI scans should be performed only in a specified MR environment under specified conditions as described in the Reveal LINQ MRI Technical Manual.

Reveal LINQ Mobile Manager System: Before inserting the Reveal LINQ ICM, verify that the patient connector and mobile device are fully charged. The patient connector and mobile device may run out of power during the insertion procedure if they are not fully charged. You will not be able to program or interrogate the patient’s Reveal LINQ ICM until the patient connector and the mobile device have power.

Only use the patient connector to communicate with the intended implanted device. Do not use the patient connector to communicate with other implanted devices. Using the patient connector to communicate with other implanted devices can interfere with those devices, potentially affecting the other implanted device’s functionality or therapy delivery.

Use of wireless devices — The patient connector incorporates radiofrequency (RF) communications components which may affect other devices and equipment in the medical environment. The use of wireless devices in the medical environment must be evaluated and authorized by the responsible organization. RF interference may affect device performance. Electromagnetic Compliance (EMC) testing shows that the patient connector provides reasonable protection against harmful interference and provides EMC immunity in a typical medical installation. The use of wireless devices in the medical environment must be evaluated and authorized by the responsible organization. However, there is no guarantee that interference will not occur in a particular installation. If the patient connector does cause harmful interference to other devices or is negatively impacted by other devices, correct the interference by one or more of the following measures: reorient or relocate the patient connector and other devices; increase the separation between the patient connector and other devices by at least two meters (approximately 6 feet); and/ or turn off any interfering equipment.

Radiofrequency (RF) interference — Portable and mobile RF communications equipment can interfere with the operation of the patient connector. There is no guarantee that it will not receive interference or that any particular transmission from this system will be free from interference. To avoid interference, do not use the patient connector and mobile device within 2 m (6 feet) of other wireless communications equipment. Using the patient connector near these devices could interfere with communication between the Reveal LINQ ICM and the patient connector.

Security — Maintain adequate physical security of the patient connector to prevent unauthorized use that could lead to harm to patients. Bluetooth® communication in the patient connector is encrypted for security. Medtronic inductive telemetry uses short-range communication to protect patient information. If the patient connector should fail, there is no risk of patient harm.

Environmental precautions — To ensure safe and effective operation, use the device with care to avoid damage to the patient connector from environmental factors that may impair its function. Care is exercised in design and manufacturing to minimize damage to devices under normal use. However, electronic devices are susceptible to many environmental stresses. Specifically, the patient connector may be affected by electrostatic discharge (ESD). In an environment likely to cause ESD, such as a carpeted floor, discharge any charge collected on your body before touching the device.

Patient Assistant
Operation of the Patient Assistant near sources of electromagnetic interference, such as cellular phones, computer monitors, etc., may adversely affect the performance of this device.

Potential Complications: Potential complications of the Reveal LINQ device include, but are not limited to, device rejection phenomena (including local tissue reaction), device migration, infection, and erosion through the skin.

See the device manuals for detailed information regarding the implant procedure, indications, contraindications, warnings, precautions, and potential complications/adverse events. For further information, please call Medtronic at 800-328-2518 and/or consult the Medtronic website at medtronic.com.

Caution: Federal law (USA) restricts these devices to sale by or on the order of a physician.

Medtronic MyCareLink patient monitor, Medtronic CareLink network, and CareLink mobile application

Intended Use: The Medtronic MyCareLink™ patient monitor and CareLink™ network are indicated for use in the transfer of patient data from some Medtronic implantable cardiac devices based on physician instructions and as described in the product manual. The CareLink mobile application is intended to provide current CareLink network customers access to CareLink network data via a mobile device for their convenience. The CareLink mobile application is not replacing the full workstation, but can be used to review patient data when a physician does not have access to a workstation. These products are not a substitute for appropriate medical attention in the event of an emergency and should only be used as directed by a physician. CareLink network availability and mobile device accessibility may be unavailable at times due to maintenance or updates, or due to coverage being unavailable in your area. Mobile device access to the internet is required and subject to coverage availability. Standard text message rates apply.

Contraindications: There are no known contraindications.

Warnings and Precautions: The MyCareLink patient monitor must only be used for interrogating compatible Medtronic implantable devices.

See the device manual for detailed information regarding the instructions for use, indications, contraindications, warnings, precautions, and potential complications/adverse events. For further information, please call Medtronic at 800-929-4043 and/or consult the Medtronic website at medtronic.com.

AccuRhythm AI ECG classification system brief statement

Indications: The intended use of the system is to reduce false positive cardiac arrhythmia episodes.

Contraindications: There are no known contraindications for AccuRhythm AI Models ZA400, ZA410, or ZA420.

Precautions: The AccuRhythm AI ECG classification system may incorrectly adjudicate a true positive episode as an AI false episode, causing that episode to be suppressed in the remote monitoring system.

See the device manual for detailed information regarding the intended use, contraindications, warnings, precautions, and potential complications/adverse events. For further information, call Medtronic Technical Services at 800-328-2518 and/or consult Medtronic’s website at www.medtronic.com.

Caution: Federal law (USA) restricts these devices to sale by or on the order of a physician.

The Bluetooth® word mark and logos are registered trademarks owned by Bluetooth SIG, Inc. and any use of such marks by Medtronic is under license.

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Alert Indications, Safety, and Warnings

LINQ II Insertable Cardiac Monitor (ICM) for cardiac monitoring

The LINQ II™ insertable cardiac monitoring system is personalized for the patient's lifestyle and customized for the clinician's workflow. LINQ II ICM is ideal for patients experiencing infrequent symptoms that require long-term monitoring or ongoing management.

Download LINQ II Brochure
LINQ II insertable cardiac monitor on transparent background
Alert Indications, Safety, and Warnings

Overview

Accuracy matters

LINQ II ICM is the world's most accurate ICM,1-13 featuring enhanced algorithms, remote programming, and 4.5-year† longevity.14

Watch this video to learn more about LINQ II ICM.

†Nominal settings.

Product details

Retained sensitivity

For greater confidence, the Atrial Fibrillation (AF) and Pause AccuRhythm™ AI algorithms further enhance the accuracy of the LINQ II ICM data.15-17

AF algorithm

99.3%
preserved true alerts16

99.96%
true AF detection retained

Pause algorithm

100%
preserved true alerts15

Discover AI algorithms

Lowest published rate of AF false positives

LINQ II ICM delivers eight times fewer false positives1,2,7,18

Chart demonstrating no published clinical evidence showing AF episode or AF sensitivity for Biotronik
Chart demonstrating the AF false positive percentages for Abbott
Chart depicting LINQ II ICM false positives

Enlarge chart

Disclaimer: A controlled, head-to-head study evaluating the comparative performance of these devices has not been done.

* Third-party brands are trademarks of their respective owners.
‡Lux-Dx™* ICM, Confirm Rx™* with SharpSense™* technology, Jot Dx™*, and BIOMONITOR™* III have no published clinical evidence showing AF episode PPV or AF sensitivity.
§ Based on AF episodes ≥ 2 minutes and in known AF patients. AF sensitivity may vary between gross and patient average.
1 Pürerfellner H, Sanders P, Sarkar S, et al. Adapting detection sensitivity based on evidence of irregular sinus arrhythmia to improve atrial fibrillation detection in insertable cardiac monitors. Europace November 1, 2018;20(FI_3):f321-f328.
2 Nölker G, Mayer J, Boldt LH, et al. Performance of an Implantable Cardiac Monitor to Detect Atrial Fibrillation: Results of the DETECT AF Study. J Cardiovasc Electrophysiol. December 2016;27(12):1403-1410.
7 BIOTRONIK BioMonitor™ 2 technical manual. 2017.
16 Radtke AP, Ousdigian KT, Haddad TD, Koehler JL, Colombowala IK. Artificial Intelligence Enables Dramatic Reduction of False Atrial Fibrillation Alerts from Insertable Cardiac Monitors. Heart Rhythm. August 1, 2021;18(8):S47.
18 Confirm Rx™* ICM DM3500 FDA clearance letter. 2017.​

Industry-exclusive PVC algorithm

The exclusive PVC detector may help identify high-risk patients.19,20

Enlarge chart

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Product features

Increased connectivity. Seamless experience.

BlueSync™ technology within LINQ II ICM enables secure, wireless communication via Bluetooth® Low Energy without compromising device longevity.14

  1. Reveal LINQ™ mobile manager
  2. LINQ II device
  3. MyCareLink Heart™ mobile app on patient's smartphone or tablet, or
  4. MyCareLink Relay™ home communicator for bedside use
  5. CareLink™ network
  6. Medtronic Get Connected and Stay Connected
CareLink network screen on a desktop computer and portrait of a woman smiling

Effortless connectivity

  • Portable Bluetooth monitoring
  • Monitor automatically detects if new data is available
  • Event notification triggers an actionable alert

No manual transmissions

  • Remote access to full ECGs eliminates the need for manual transmissions14
  • Decreases patient action and confusion

Enhanced patient compliance

  • Automatic smartphone notifications help patients stay connected
  • Reduces clinic time spent on patient follow-up

First ICM with remote programming||14

LINQ II ICM enables remote programming capability for all device parameters post-insertion from the clinic, which may reduce patient office visits and scheduling hassles.

Man with a gray beard looking at his mobile phone outside with trees in the background

Patient data transmitted to CareLink network via MyCareLink Relay or MyCareLink Heart

Female healthcare professional wearing scrubs while typing on a computer

Clinician-initiated reprogramming via CareLink network

MyCareLink Relay home communicator and MyCareLink Heart mobile app monitors

Monitors act as a
pass-through

Man with a gray beard looking at his mobile phone outside with trees in the background

Device settings automatically update without need for an office visit

||First European-approved (TÜV notified body) remote programmable device.

More time to focus on patient care

AccuRhythm AI algorithms can save clinicians approximately 319 hours of false alert review yearly for every 200 LINQ II ICM patients.¶21

  

84%
reduction in LINQ II false alerts21

319
hours reduction in clinic review time¶21

The validation study performance and time study results were projected onto 16,301 LINQ II patients to calculate the time saved per year in 200 LINQ II ICM patients.

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Model Specifications 

pdf LINQ II product specifications (.pdf)

Download the specifications sheet for details on the LINQ II insertable cardiac monitor.

151KB

Document thumbnail

Resource library

Related pages

Medtronic 24-hour support

1-800-505-4636

Educational resources on Medtronic Academy

Access interactive courses, videos, and educational resources to extend your learning on LINQ II ICM.

Visit Medtronic Academy

Medtronic, Medtronic logo, and Engineering the extraordinary are trademarks of Medtronic. The Bluetooth® word mark and logos are registered trademarks owned by Bluetooth SIG, Inc. and any use of such marks by Medtronic is under license. ™Other third party brands are trademarks of their respective owners. All other brands are trademarks of a Medtronic company. Apple and the Apple logo are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc.

*

Third-party brands are trademarks of their respective owners.

†

Nominal settings.

‡

Lux-Dx™* ICM, Confirm Rx™* with SharpSense™* technology, Jot Dx™*, and BIOMONITOR™* III have no published clinical evidence showing AF episode PPV or AF sensitivity.

§

Based on AF episodes ≥ 2 minutes and in known AF patients. AF sensitivity may vary between gross and patient average.

||

First European-approved (TÜV notified body) remote programmable device.

The validation study performance and time study results were projected onto 16,301 LINQ II patients to calculate the time saved per year in 200 LINQ II ICM patients.

References

1

Pürerfellner H, Sanders P, Sarkar S, et al. Adapting detection sensitivity based on evidence of irregular sinus arrhythmia to improve atrial fibrillation detection in insertable cardiac monitors. Europace. November 2018;20(FI_3):f321-f328.

2

Nölker G, Mayer J, Boldt L, et al. Performance of an Implantable Cardiac Monitor to Detect Atrial Fibrillation: Results of the DETECT AF Study. J Cardiovasc Electrophysiol. December 2016;27(12):1403-1410.

3

Confirm Rx™ ICM K163407 FDA clearance letter. 2017.

4

Confirm Rx ICM K182981 FDA clearance letter. 2019.

5

Jot Dx™ ICM K212206 FDA clearance letter. 2021.

6

Monitoring Devices Merlin PCS Help Manual for SJM Confirm, Confirm Rx ICM, Jot Dx Manual. 2021.

7

BIOTRONIK BioMonitor™ 2 technical manual. 2017.

8

BIOTRONIK BIOMONITOR III technical manual. 2020.

9

BIOTRONIK BIOMONITOR IIIm technical manual. 2020.

10

BIOTRONIK BIOMONITOR III. K190548 FDA clearance. 2019.

11

BIOTRONIK BIOMONITOR IIIm. K201865 FDA clearance. 2020.

12

Lux-Dx™ ICM K212206 FDA clearance letter. 2020.

13

Lux-Dx ICM user manual. 2020.

14

LINQ II™ LNQ22 ICM clinician manual. M974764A001D.

15

Cheng YJ, Ousdigian KT, Koehler J, Cho YK, Kloosterman M. Innovative Artificial Intelligence Application Reduces False Pause Alerts while Maintaining Perfect True Pause Sensitivity for Insertable Cardiac Monitors. Presented at HRS 2021.

16

Radtke AP, Ousdigian KT, Haddad TD, Koehler JL, Colombowala IK. Artificial Intelligence Enables Dramatic Reduction of False Atrial Fibrillation Alerts from Insertable Cardiac Monitors. Heart Rhythm. August 1, 2021;18(8):S47.

17

AccuRhythm clinician manual supplements M015316C001 and M015314C001.

18

Confirm Rx™* ICM DM3500 FDA clearance letter. 2017.

19

Penela D, Fernández-Armenta J, Aguinaga L, et al. Clinical recognition of pure premature ventricular complex-induced cardiomyopathy at presentation. Heart Rhythm. December 2017;14(12):1864-1870.

20

Penela D, Van Huls Van Taxis C, Aguinaga L, et al. Neurohormonal, structural, and functional recovery pattern after premature ventricular complex ablation is independent of structural heart disease status in patients with depressed left ventricular ejection fraction: a prospective multicenter study. J Am Coll Cardiol. September 24, 2013;62(13):1195-1202.

21

Ousdigian K, Cheng YJ, Koehler J, et al. Artificial Intelligence Dramatically Reduces Annual False Alerts from Insertable Cardiac Monitors. Presented at AHA Conference 2021.