Arrhythmias & electrophysiology
Accuracy of Implantable Loop Recorders: Multicenter, Multidevice Comparison
Authors' conclusion
ILRs demonstrate variable accuracy in arrhythmia detection, with a substantial burden of false-positive alerts across all vendors despite artificial intelligence-based and other algorithmic enhancements. Further improvement of alert algorithms to reduce clinic burdens is needed.
Study context
- Population
- Patients with implantable loop recorders (medtronic (MDT) LINQ II, BSX LUX-Dx, Biotronik (BIO) Biomonitor III, Abbott (ABT) Confirm Rx), January 2022 to March 2023random sample (∼283 per device) from a database of 437,351 electrocardiogram-verified episodes from 6,756 patients
- Participants
- 1,140 patients
- Exposure
- Arrhythmia detection accuracy among currently used implantable loop recorders (ILRs)
- Outcome
- Total alerts
Methodological detailsrandom sample selected based on a prospectively determined power analysis, alerts independently adjudicated by trained physicians, 25 centers
- Random sample selected based on a prospectively determined power analysis
- Alerts independently adjudicated by trained physicians
- 25 centers
Main finding
As reported in the abstract
Total alerts
25,826
Alerts per patient
median of 5 alerts
IQR: 2–14
Observational data: associations, not effects.
Further findings
Atrial tachycardia/AF alerts (share of alerts)
PPV
| Outcome | MDT | BSX | BIO | ABT |
|---|---|---|---|---|
| PPV after adjudication | 0.56 | 0.73 | 0.23 | 0.51 |
| Bradycardia detection PPVMDT primarily due to undersensing | 0.36 | 0.96 | — not stated in the abstract | — not stated in the abstract |
| Pause detection PPV | — not stated in the abstract | 0.70 | — not stated in the abstract | 0.01 |
| Tachycardia alert PPV | 0.29 | 0.61 | 0.62 | 0.27 |
— not stated in the abstract
- Pause detection PPV: ABT 79.8% due to undersensing
Causes of false-positive atrial tachycardia/atrial fibrillation (AF) alerts with BIO devices
- Ectopy
- 75.8%
- Combined ectopy with oversensing/noise
- 5.3%
- Isolated oversensing
- 5.2%
- Sinus arrhythmias
- 3.9%
- Indeterminate reason
- 3.7%
- Noise
- 3.6%
- Bradycardia
- 2.5%
Original publication
Accuracy of Implantable Loop Recorders: Multicenter, Multidevice Comparison. JACC Clin Electrophysiol. Published 13 February 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →