Remote Monitoring of Implantable Loop Recorders: False-Positive Alert Episode Burden

Implantable loop recorders (ILRs) are widely recognized as an important diagnostic tool in patients with suspected arrhythmia, providing an opportunity for long-term cardiac rhythm monitoring. The emergence of remote monitoring (RM) for cardiac implantable electronic device follow-up 1 has facilitated timely recognition of ILR-detected arrhythmias; however, the volume of alert transmissions is burdensome for clinics and clinicians, with ILRs transmitting disproportionately high-alert quantities in comparison to other cardiac implantable electronic devices.2 By their subcutaneous nature, ILRs are prone to a variety of erroneous activations.3,4 Additionally, ILR alert burden is supplemented by patient-activated alerts, which often do not correspond with significant arrhythmia.5 Although small single-center reports have described false-positive ILR alerts, there is no multicenter experience regarding the RM burden of ILRs and frequency of false-positive alerts. We aimed to characterize ILR alert burden in a large multicenter cohort with the Reveal LINQ device.