2020 Volume 40 Issue 2 Pages 84-89
Background : The recommended implantation site and direction of the Reveal LINQ Insertable cardiac monitor（Medtronic Inc, Minneapolis, Minnesota）is the left 4th intercostal space in an oblique direction. However, the feasibility of the recommended implantation site and direction has not been fully investigated. The purpose of this study was to investigate the optimal positioning of the Reveal LINQ. Methods : From September 2017 to June 2019, 25 patients scheduled to be implanted with a Reveal LINQ were studied. The QRS amplitudes of the body surface ECG at each site and direction were measured. Measurements sites were the 3rd, 4th, and 5th intercostal spaces. The measurements were in the vertical, horizontal, and oblique directions. Therefore, a total of nine QRS amplitudes were measured for each patient. After mapping, the Reveal LINQ was implanted in the maximum QRS amplitude site and direction. The preprocedural body surface QRS amplitude and postoperative QRS amplitude measured by the Reveal LINQ were compared. Results : The preprocedural body surface QRS amplitude and postoperative QRS amplitude were well correlated. The maximum QRS amplitude was obtained at the recommended implantation site and direction in only 13 patients（52％）. Conclusion : Preprocedural QRS amplitude mapping was useful to determine the optimal implantation site and direction. The recommended site and direction were not always the optimal site and direction.
