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View 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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ATRIAL FIBRILLATION MANAGEMENT CARDIAC DIAGNOSTICS & MONITORING

Ongoing cardiac monitoring for the management of atrial fibrillation
Alert Important Safety Information

MONITORING PATIENTS

Patients with asymptomatic episodes are at equal risk for stroke as symptomatic patients.1

  • 69% of patients had at least one AF recurrence2
  • 56% of the recurrent AF being asymptomatic*3
  • 3X increase in asymptomatic episodes post-ablation3

Pie chart showing patients with asymptomatic episodes are at equal risk for stroke as symptomatic patients

HRS AF Ablation Guidelines

  • Prior to undergoing a catheter ablation procedure, it is important to confirm that a patient’s symptoms result from AF and to determine whether a patient has paroxysmal or persistent AF. This is of importance as the ablation technique, procedure outcome, and anticoagulation strategies employed … may be impacted by the accurate characterization of the AF type and burden.4
  • Patients in whom discontinuation of systemic anticoagulation is being considered should consider undergoing continuous ECG monitoring to screen for asymptomatic AF/AFL/AT.5
Reveal LINQ ICM on blue background

Cardiac Monitoring for your AF Patients

Continuous cardiac monitoring leads to more actionable events than conventional monitoring.6

Build a diagnostic picture by continuously monitoring AF burden, heart rate variability, and daily activity with Reveal LINQ™ insertable cardiac monitor (ICM).

Reveal LINQ ICM provides physicians with longitudinal data to objectively determine both asymptomatic and symptomatic AF. This data results in the measure of true AF burden and accurate characterization of the AF type to effectively guide therapy decisions.3,7

data-driven decisions

  1. AT/AF total time per day 
    This trend data is based on a count of 2-minute periods when an AT/AF episode is detected or in progress.
  2. Ventricular rate during AT/AF
    The daily average ventricular rate is derived from the number of ventricular beats during AT/AF episodes and the total time in AT/AF for that day.
  3. Average ventricular rate
    The average day and night heart rates are derived from the sum and number of R-R intervals during the periods defined as “day” and “night.”
  4. Patient activity
    The sum of patient activity in hours per day.

  5. Heart rate variability 
    Median ventricular interval calculated every 5 minutes.

CARDIAC COMPASS™ REPORT  — 90-DAY VIEW

Graph of a Cardiac Compass Report showing AF

Arrhythmia Management

Reveal LINQ ICM allows physicians to continually monitor the ongoing change in AF burden so that treatment can be initiated or changed on a timely basis.8-10

  • Case planning guidance
  • Symptom-rhythm correlation
  • Assessment of drug therapy
  • Objective measurement of AF burden
  • Determination of therapy success
    (e.g., post-AF ablation cardioversion)

CareAlert™ notifications†

Allow for customization by clinic and/or individual patient.

  • AF of any duration
  • AF burden
  • Ventricular rate
  • Symptom + Auto Detect
  • Ventricular rate during AF burden

 

INDUSTRY-LEADING  TruRhythm DETECTION

Our newest detection algorithms streamline
episode review without sacrificing sensitivity.

INTELLIGENT

decorative element

Smart filtering algorithm improves detection accuracy for Brady & Pause. 

ACTIONABLE

decorative element

Streamlined episodes & report updates simplify data review. 

EXCLUSIVE ALGORITHMS

decorative element

Significantly reduce false positives while preserving sensitivity.10,11

Features 

  • 99.7%: Highest published AF detection accuracy on the market streamlines data review13
  • 3 years: Up to 3-year longevity for long-term monitoring14
  • MRI Conditional: Safe for MRI at 1.5 and 3.0T even on the same day of insertion‡14

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EXPERIENCE THE REVEAL LINQ ADVANTAGE

Learn how Reveal LINQ ICM compares for accuracy and longevity.

SEE THE DIFFERENCE
*

Based on clinical evidence.

†

Medtronic CareAlert™ notifications are not intended to be used as the sole basis for making decisions about patient medical care.

‡

Reveal LINQ has been demonstrated to pose no known hazards in a specified MRI environment with specified conditions of use. Please see the Reveal™ ICM clinician manual or MRI technical manual for more details.

1

Bakhai A, Darius H, De Caterina R, et al. Characteristics and outcomes of atrial fibrillation patients with or without specific symptoms. Eur Heart J Qual Care Clin Outcomes. October 1, 2016;2(4):299-305.

2

Tondo C, Tritto M, Landolina M, et al. Rhythm-symptom correlation in patients on continuous monitoring after catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. February 2014;25(2):154-160.

3

Verma A, Champagne J, Sapp J, et al. Discerning the Incidence of Symptomatic and Asymptomatic Episodes of Atrial Fibrillation Before and After Catheter Ablation (DISCERN AF): a prospective, multicenter study. JAMA Intern Med. January 28, 2013;173(2):149-156.

4

Calkins H, Kuck KH, Cappato R, et al. 2012 HRS/EHRA/ECAS expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. Heart Rhythm. April 2012;9(4):632-696.

5

Calkins H, Hindricks G, Cappato R, et al. 2017 HRS/EHRA/ECAS/APHRS/ SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Europace. January 1, 2018;20(1):e1-e160.

6

Kapa S, Epstein AE, Callans DJ, et al. Assessing arrhythmia burden after catheter ablation of atrial fibrillation using an implantable loop recorder: the ABACUS study. J Cardiovasc Electrophysiol. August 2013;24(8):875-881.

7

Wechselberger S, Kronborg M, Huo Y, et al. Continuous monitoring after atrial fibrillation: the LINQ AF study. Europace. November 1, 2018;20(FI_3):f312-f320.

8

Sinha S. The Impact of Atrial Fibrillation: Paroxysmal Atrial Fibrillation: Diagnosis, Progression, and Stroke Risk. MedPageToday. Available at: https://archive.li/DU7LI. Accessed February 25, 2019.

9

Mascarenhas DA, Farooq MU, Ziegler PD, Kantharia BK. Role of insertable cardiac monitors in anticoagulation therapy in patients with atrial fibrillation at high risk of bleeding. Europace. June 2016;18(6):799-806.

10

Passman R, Bernstein RA. New Appraisal of Atrial Fibrillation Burden and Stroke Prevention. Stroke. February 2016;47(2):570-576.

11

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(Fl_3):f321-f328.

12

Passman RS, Rogers JD, Sarkar S, et al. Development and validation of a dual sensing scheme to improve accuracy of bradycardia and pause detection in an insertable cardiac monitor. Heart Rhythm. July 2017;14(7):1016-1023.

13

TruRhythm Detection Algorithms. Medtronic data on file. 2017.

14

Reference the Reveal LINQ ICM Clinician Manual for usage parameters.