Continuous Cardiac Monitoring is Cost-Effective
In addition, results from a new analysis (based on the AF detection rates found in the randomized CRYSTAL AF study) demonstrated for the first time that the use of long-term, continuous cardiac monitoring is a cost-effective method of detecting AF in cryptogenic stroke patients. Presented at the International Stroke Conference, the incremental cost-effectiveness ratio (ICER) associated with the Reveal XT ICM in the study compared with the present standard-of-care, was well within the cost effectiveness range that the United Kingdom's National Institute of Clinical Excellence (NICE) considers acceptable based on an established cost effectiveness threshold, recently set by NICE to be Pounds20,000 per Quality Adjusted Life Year (QALY). (A QALY is combination of the quantity and quality of life; it is calculated by adjusting the estimated number of life-years a patient is expected to gain from an intervention by the expected quality of life in those years.)

In the CRYSTAL AF study, detection of AF with the long-term cardiac monitor was superior to conventional monitoring methods (30.0 percent with the ICM, and 3.0 percent with standard monitoring at 3 years; p=<0.0001) that are the current standard of care over a three-year follow up.


"These results show that continuous cardiac monitoring with an ICM is a cost-effective tool," said Klaus Witte, M.D., FRCP, FESC, FACC, associate professor and consultant cardiologist, and lead clinician for cardiology at the University of Leeds and Leeds Teaching Hospitals NHS Trust in the United Kingdom. "Detecting AF in cryptogenic stroke patients enables physicians to change their medical therapy so we can reduce their risk of having a second stroke."

Cleared by the FDA last year, the Reveal LINQ ICM System is the newest generation of ICM and the smallest cardiac monitor available (~1 cc, or one-third the size of a AAA battery). Common uses include monitoring syncope patients for potential episodes of bradycardia/asystole, monitoring cryptogenic stroke patients for possible episodes of AF, and monitoring patients suffering from intermittent chest palpitations for potential episodes of atrial or ventricular arrhythmias.

Like its predecessor, this even smaller LINQ device is placed under the skin of the chest, and its battery allows for up to three years of monitoring. Additionally, the device communicates wirelessly with a patient bedside monitor that uploads device data to the Medtronic CareLink® network.

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