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Monday, March 17, 2014, 6:50 am

St. Joseph doctors first in Bay Area to implant new Medtronic device

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    Medtronic Reveal LINQ insertable cardiac monitor

    About the size of a AAA battery, the Medtronic Reveal LINQ cardiac monitor is inserted just beneath the skin in the upper chest area and continuously records heart rhythms over long periods of time.

    SANTA ROSA — Cardiologists at two St. Joseph Health-affiliated facilities, Santa Rosa Memorial Hospital and the nearby Advanced Surgery Institute, recently implanted a new miniature cardiac monitoring device used to continuously and wirelessly monitor a patient’s heart, becoming the Bay Area’s first to offer the minimally invasive alternative to larger implants, officials said.

    Officials from the health system said  the tiny implant made by Medtronic, called the Reveal LINQ Insertable Cardiac Monitor, is the world’s smallest implantable heart monitor. It measures about a third of the size of an AAA battery, and local 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 Dr. Peter Chang-Sing, medical director of Santa Rosa Memorial’s Cardiac Electrophysiology Lab and a member of Medtronic’s national electrophysiology advisory board.

    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, this year to treat patients experiencing symptoms such as dizziness, palpitation, fainting and chest pain that may suggest a cardiac arrhythmia, and for patients at increased risk for cardiac arrhythmias, according to officials involved.

    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 Dr. Thomas Dunlap, 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 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, 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 where Dr. Chang-Sing implanted the center’s first Reveal LINQ monitor in a patient.  “With the smaller incision, it’s less invasive and lowers the risk of infection,” said Ms. Hurd of ASI, in 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.

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