P-wave detection performance of the BioMonitor III, Confirm Rx and Reveal Linq implantable loop recorders

Area of Science:

• Cardiology
• Biomedical Engineering
• Electrophysiology

Background:

• P-wave visibility on electrograms (EGMs) from implantable loop recorders (ILRs) aids rhythm interpretation.
• Common ILRs (BioMonitor III, Confirm Rx, Reveal Linq) differ in design, potentially affecting EGM quality.
• Variations in p-wave visibility and amplitude across devices require investigation.

Purpose of the Study:

• To compare p-wave visibility and amplitude across three commonly used ILRs: BioMonitor III, Confirm Rx, and Reveal Linq.
• To assess the impact of device characteristics on the ease of rhythm interpretation from ILR EGMs.

Main Methods:

• 148 patients with ILRs (BioMonitor III, Confirm Rx, or Reveal Linq) were analyzed.
• P-wave visibility and amplitude were evaluated on 30-second EGMs at standard and maximum resolutions.
• Surface ECG lead II p-wave amplitude and patient baseline characteristics were recorded.

Main Results:

• P-waves were visible in most patients across all devices (83% BioMonitor III, 71% Confirm Rx, 71% Reveal Linq) at standard resolution.
• BioMonitor III demonstrated significantly higher p-wave amplitudes compared to Confirm Rx and Reveal Linq.
• P-wave visibility after maximum magnification showed no significant difference between devices, though slightly more p-waves were unidentifiable in Confirm Rx.

Conclusions:

• BioMonitor III ILR yields higher p-wave amplitudes compared to Confirm Rx and Reveal Linq.
• Despite amplitude differences, p-wave visibility for rhythm interpretation was comparable across the three ILR models.
• Device-specific characteristics do not significantly impede p-wave identification for rhythm analysis in these ILRs.