In-office insertion of a miniaturized insertable cardiac monitor: Results from the Reveal LINQ In-Office 2 randomized study

Rogers, John; Sanders, Prashanthan; Piorkowski, Christopher; Sohail, M. Rizwan; Anand, Rishi; Crossen, Karl J.; Khairallah, Farhat; Kaplon, Rachelle E.; Stromberg, Kurt; Kowal, Robert C.

doi:10.1016/j.hrthm.2016.11.001

Cited by 39 publications

(38 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…investigated the safety and adverse events following injectable INR implantation in the hospital setting versus in the office setting. No significant difference in the rate of successful injectable ILR implantation (100% successful device implantation in both settings) or procedure‐related adverse events (2.5% in the office setting and 4.4% in the hospital setting, P = 0.124) was observed following device implantation in either setting . In contrast to the present cohort study, Rogers et al.…”

Section: Discussioncontrasting

confidence: 78%

Injectable loop recorder implantation in an ambulatory setting by advanced practice providers: Analysis of outcomes

Kipp

Young

Barnett

et al. 2017

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

Section: Discussioncontrasting

confidence: 78%

Injectable loop recorder implantation in an ambulatory setting by advanced practice providers: Analysis of outcomes

Kipp

Young

Barnett

et al. 2017

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

“…In our study, we went one step further by introducing a nurse‐led office‐based LINQ‐ILR service. Our results for in‐office implants are comparable with published data, showing similar infection and complication rates …”

Section: Discussionsupporting

confidence: 91%

“…Our results for in-office implants are comparable with published data, showing similar infection and complication rates. 18,19 Our data suggest that the nurse-led approach is a safe alternative to a physician-led service. This is more likely driven by the ease of implantation of modern day ILRs, where operators can be proficient after a short period of training.…”

Section: Discussionmentioning

confidence: 78%

See 1 more Smart Citation

A nurse‐led implantable loop recorder service is safe and cost effective

Lim

Papageorgiou

Sukumar

et al. 2019

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Introduction Implantable loop recorders (ILR) are predominantly implanted by cardiologists in the catheter laboratory. We developed a nurse‐delivered service for the implantation of LINQ (Medtronic; Minnesota) ILRs in the outpatient setting. This study compared the safety and cost‐effectiveness of the introduction of this nurse‐delivered ILR service with contemporaneous physician‐led procedures. Methods Consecutive patients undergoing an ILR at our institution between 1st July 2016 and 4th June 2018 were included. Data were prospectively entered into a computerized database, which was retrospectively analyzed. Results A total of 475 patients underwent ILR implantation, 271 (57%) of these were implanted by physicians in the catheter laboratory and 204 (43%) by nurses in the outpatient setting. Six complications occurred in physician‐implants and two in nurse‐implants (P = .3). Procedural time for physician‐implants (13.4 ± 8.0 minutes) and nurse‐implants (14.2 ± 10.1 minutes) were comparable (P = .98). The procedural cost was estimated as £576.02 for physician‐implants against £279.95 with nurse‐implants, equating to a 57.3% cost reduction. In our center, the total cost of ILR implantation in the catheter laboratory by physicians was £10 513.13 p.a. vs £6661.55 p.a. with a nurse‐delivered model. When overheads for running, cleaning, and maintaining were accounted for, we estimated a saving of £68 685.75 was performed by moving to a nurse‐delivered model for ILR implants. Over 133 catheter laboratory and implanting physician hours were saved and utilized for other more complex procedures. Conclusion ILR implantation in the outpatient setting by suitably trained nurses is safe and leads to significant financial savings.

show abstract

“…Based on prior reports, patients are usually more satisfied with office based surgery because of the convenience and lack of delays [3,4]. A study compared the safety of ICM insertion in an office setting to those performed in a hospital [5]. That study showed no significant difference in safety or efficacy.…”

Section: Introductionmentioning

confidence: 99%

BioMonitor 2 in-office setting insertion safety and feasibility evaluation with device functionality assessment: results from the prospective cohort BioInsight study

Awad¹,

Weiss²,

Yunus³

et al. 2020

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background: Insertable cardiac monitors are utilized for the diagnosis of arrhythmias and traditionally have been inserted within hospitals. Recent code updates allow for reimbursement of office-based insertions; however, there is limited information regarding the resources and processes required to support in-office insertions. We sought to determine the safety and feasibility of in-office insertion of the BioMonitor 2 and better understand in-office procedures, including patient selection, pre-insertion protocols, resource availability, and staff support.Methods: Patients meeting an indication for a rhythm monitor were prospectively enrolled into this single-arm, non-randomized trial. All patients underwent insertion in an office setting. Two follow-up visits at days 7 and 90 were required. Information on adverse events, device performance, office site preparations, and resource utilization were collected.Results: Eighty-two patients were enrolled at six sites. Insertion was successful in all 77 patients with an attempt. Oral anticoagulation was stopped in 20.8% of patients and continued through insertion in 23.4%, while prophylactic antibiotics were infrequently utilized (37.7% of study participants). On average, the procedure required a surgeon plus two support staff and 35 min in an office room to complete the 8.4 min insertion procedure. The mean R-wave amplitude was 0.77 mV at insertion and 0.67 mV at 90-days with low noise burden (2.7%). There were no procedure related complications. Two adverse events were reported (event rate 2.7% [95% CI 0.3, 9.5%]). Conclusions:In-office insertion of the BioMonitor 2 is safe and feasible. Devices performed well with high R-wave amplitudes and low noise burden. These results further support shifting cardiac monitor insertions to office-based locations.

show abstract

In-office insertion of a miniaturized insertable cardiac monitor: Results from the Reveal LINQ In-Office 2 randomized study

Cited by 39 publications

References 20 publications

Injectable loop recorder implantation in an ambulatory setting by advanced practice providers: Analysis of outcomes

Injectable loop recorder implantation in an ambulatory setting by advanced practice providers: Analysis of outcomes

A nurse‐led implantable loop recorder service is safe and cost effective

BioMonitor 2 in-office setting insertion safety and feasibility evaluation with device functionality assessment: results from the prospective cohort BioInsight study

Contact Info

Product

Resources

About