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!

Introduction Limited data is available regarding the novel Reveal LinQ™ (LinQ) which is a new generation implantable loop recorders (ILRs). Methods We performed a prospective, observational study of all consecutive patients undergoing conventional (Reveal XT™; XT) and LinQ devices at our institution between January 2012 and December 2014. Results A total of 217 patients underwent ILR implantation. XT was implanted in 105 and LinQ in 112 patients. There were no significant differences in baseline characteristics between the two groups. LinQ implantation using the manufacturer's technique termed, "manufacturer's method" group had significantly higher incidence of pocket infection compared to XT (6/50, 12% vs 3/105, 3%, p = 0.032). With modifications to the LinQ implantation technique (using a conventional scalpel and placing a suture when needed to the incision) termed "modified method" group, the rate of infection has decreased significantly compared to "manufacturer's method group" (0/62, 0% vs 6/50, 12%, p = 0.004) (Table 3). In multivariate regression analysis, the only independent predictors of infection were younger age (OR 0.95; p = 0.04), insertion of LinQ device (OR 30.02; p = 0.006) and procedure time (OR 1.07; p = 0.03). Conclusion In our single-center, prospective, observational study we found that with the current implantable techniques, the novel insertable LinQ device is associated with increased risk of complications.