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在一家三级医疗中心,将新型可插入式(美敦力Reveal LinQ(@))与传统的(美敦力Reveal XT(@))植入式环形记录仪的初步真实世界经验——值得思考的要点!

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!

作者信息

Gunda Sampath, Reddy Yeruva Madhu, Pillarisetti Jayasree, Koripalli Sandeep, Jeffery Courtney, Swope Jeanine, Atkins Donita, Bommana Sudharani, Emert Martin P, Pimentel Rhea, Dendi Raghuveer, Berenbom Loren D, DiBiase Luigi, Natale Andrea, Lakkireddy Dhanunjaya

机构信息

University of Kansas Hospital, Kansas City, KS, United States.

Texas Cardiac Arrhythmia Institute, Austin, TX, United States.

出版信息

Int J Cardiol. 2015 Jul 15;191:58-63. doi: 10.1016/j.ijcard.2015.04.241. Epub 2015 May 1.

Abstract

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.

摘要

引言

关于新一代植入式循环记录仪(ILR)——新型Reveal LinQ(LinQ)的可用数据有限。

方法

我们对2012年1月至2014年12月期间在我院接受传统(Reveal XT;XT)和LinQ设备植入的所有连续患者进行了一项前瞻性观察研究。

结果

共有217例患者接受了ILR植入。105例患者植入了XT,112例患者植入了LinQ。两组患者的基线特征无显著差异。与XT相比,采用制造商技术(称为“制造商方法”组)植入LinQ时囊袋感染发生率显著更高(6/50,12%对3/105,3%,p = 0.032)。对LinQ植入技术进行改进(使用传统手术刀并在必要时对切口进行缝合),称为“改良方法”组,与“制造商方法组”相比,感染率显著降低(0/62,0%对6/50,12%,p = 0.004)(表3)。在多因素回归分析中,感染的唯一独立预测因素是年龄较小(OR 0.95;p = 0.04)、植入LinQ设备(OR 30.02;p = 0.006)和手术时间(OR 1.07;p = 0.03)。

结论

在我们的单中心前瞻性观察研究中,我们发现采用当前的植入技术,新型可插入式LinQ设备与并发症风险增加相关。

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