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Innovative stroke detection monitor given green light

Implant could prevent hundreds of strokes, says NICE

Jo Carlowe

Tuesday, 14 January 2020

Hundreds of strokes of unknown cause could be prevented with a new implantable monitor that transmits data to doctors remotely, following draft guidance published today.

The National Institute for Health and Care Excellence (NICE) recommends the Reveal LINQ monitor, developed by Medtronic, for routine NHS adoption.

Data presented to the NICE diagnostics advisory committee showed atrial fibrillation after a cryptogenic stroke was detected in five times more people using a Reveal monitor for six months compared with people who didn’t have the device implanted.

Undiagnosed atrial fibrillation is believed to be responsible for a significant portion of the 30,000 cryptogenic strokes that occur each year in the United Kingdom.

Cryptogenic stroke patients have a high risk of recurrent stroke and require a confirmed atrial fibrillation diagnoses to receive appropriate preventive therapy.

One third of the size of a AAA battery, the monitor is implanted under the skin in the chest usually under local anaesthetic, to track a heart’s activity over long periods of time, transmitting data back to the patient’s doctor via a mobile phone network.

Clinical experts highlighted that it is important that non-invasive ECG monitoring is carried out first before Reveal LINQ is considered.

The cost of the Reveal LINQ is £1,800 plus the cost of implanting the device. It was assumed in the assessment that people with an implantable cardiac monitor would have one face-to-face follow up a month after the procedure and then would be remotely monitored.

Meindert Boysen, director of the NICE Centre for Health Technology Evaluation, said: “This is an innovative monitor which has the potential to reduce the number of strokes suffered by those with atrial fibrillation.

“It may mean fewer hospital visits for those with atrial fibrillation; reduce the need for rehabilitation and mean patients are reassured that AF will be detected in a timely manner so treatment can begin.

“This device can provide a level of reassurance to those who live in fear of having another stroke and we believe Reveal LINQ is likely to be a cost-effective use of NHS resources.”

Minister for Innovation Nicola Blackwood said: “It is fantastic to see innovative technology being adopted to vastly improve the lives of those with conditions that can be extremely debilitating, particularly patients at risk of having multiple strokes.”

NICE diagnostic guidance is non-mandatory, but it is considered best practice for the NHS to implement it.

A consultation on the draft recommendations is now underway until 4th February 2020.

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