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In The News

St. Joseph Health-Affiliated Hospital and Outpatient Surgical Center Cardiologists are the Bay Area’s First to Implant Miniature, Wireless Cardiac Monitor

Cardiologists at two St. Joseph Health-affiliated facilities, Santa Rosa Memorial Hospital and the nearby Advanced Surgery Institute, today implanted a new miniature cardiac monitoring device used to continuously and wirelessly monitor a patient’s heart, becoming the San Francisco Bay Area’s first to offer the minimally invasive alternative to larger implants. The tiny, innovative implant made by Medtronic, called the Reveal LINQ Insertable Cardiac Monitor (ICM), is the world’s smallest implantable heart monitor – measuring about a third of the size of an AAA battery. Northern California Medtronic representatives confirmed the new monitors were the first of their kind to be implanted by any Bay Area provider, and among the first in the state. 
“The LINQ is 80 percent smaller than other implantable cardiac monitors. That’s the main advantage,” said Peter Chang-Sing, MD, Medical Director of Santa Rosa Memorial’s Cardiac Electrophysiology Lab and a member of Medtronic’s national electrophysiology advisory board, which oversaw the device’s inception and development. 
The device is inserted using a syringe-like instrument during a 10-minute procedure under local anesthetic, as cardiologists place the monitor under the skin through a 1-centimeter incision in the chest. No sutures are required and, once implanted, the device is nearly imperceptible to the naked eye. The monitor was cleared for U.S. use by the federal Food and Drug Administration on Feb. 19, 2014, to treat patients experiencing symptoms such as dizziness, palpitation, syncope (fainting) and chest pain that may suggest a cardiac arrhythmia, and for patients at increased risk for cardiac arrhythmias. 
An arrhythmia is a disturbance in the heart’s normal rhythm, and there are many types – involving a too-slow heartbeat, too-rapid heartbeat, or an irregular heartbeat, for example. Many patients are “asymptomatic,” meaning their arrhythmia may represent a silent threat which they seldom if ever recognize on their own. The LINQ automatically detects an abnormal rhythm even if a patient doesn’t proactively activate it, said Thomas E. Dunlap, MD, Regional Director of Cardiac and Vascular Services at Santa Rosa Memorial. 
“The beauty of this device is that it’s so small that it’s very atraumatic for the patient, while allowing us to very accurately assess whether a patient has a potentially life-threatening arrhythmia,” said Dr. Dunlap, who today implanted the monitor in the first patient to receive one at Santa Rosa Memorial’s Heart & Vascular Institute. “You can obtain details about the patient’s heart rhythm in close to real time. Very quickly, it will transmit any rhythm disturbances to alert a clinician without the patient having to recognize any symptoms on his own, and it can distinguish between different types of arrhythmia.” 
The device can be safely implanted even in patients who are taking anticoagulants (blood-thinning medications), Dr. Dunlap added. 
Through the device’s continuous monitoring, heart specialists can assess the efficacy of drug treatment or catheter ablation in patients who have arrhythmias such as atrial fibrillation, Dr. Chang-Sing said. 
The simplicity of the implantation procedure increases patient comfort, convenience and safety, according to Ann Hurd, RN, Administrator and Director of Nursing at the Advanced Surgery Institute (ASI), where Dr. Chang-Sing implanted the center’s first Reveal LINQ monitor in a patient today. 
“With the smaller incision, it’s less invasive and lowers the risk of infection,” said Hurd of ASI, of which Santa Rosa Memorial owns a 51 percent share. 
The device can wirelessly monitor a patient’s heart for up to three years, with 20 percent more data memory than its larger predecessor, Medtronic’s Reveal XT (shown below, in comparison to its smaller successor). In addition to its continuous and wireless monitoring capabilities, the system provides remote monitoring through the Carelink® Network. Through the Carelink Network, physicians can request notifications to alert them if their patients have had cardiac events. 
The Reveal LINQ ICM allows patients to undergo testing using magnetic resonance imaging (MRI), if needed. Its simplified remote monitoring system uses global cellular technology, enabling patients’ diagnostic data to be transmitted to their doctors from nearly any location in the world.

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