Placement of Reveal LINQ Device in the Left Anterior Axillary Position

  • Heather Anderson
  • Joseph Dearani
  • M. Yasir Qureshi
  • Kimberly Holst
  • Patrick O’Leary
  • Bryan Cannon
  • Philip WackelEmail author
Original Article


Implantable loop recorders (ILR) are utilized for long-term rhythm monitoring. Typical placement of the Medtronic Reveal LINQ along the left parasternal border may compromise the quality and/or feasibility of future imaging studies. We sought to evaluate the utility of placing an ILR in the left anterior axillary position and the impact on the quality of cardiac imaging. We reviewed patients from May 2017 to June 2018 who had placement of a Reveal LINQ device in the left anterior axillary position. Demographic, procedural, and clinical data were collected via retrospective review. Cardiac magnetic resonance imaging (MRI) studies were reviewed for image quality after ILR placement. Eight patients met inclusion criteria for this study (median age 6 years, 50% female). Six patients (75%) had an ILR placed in the operating room, while all others were placed in the electrophysiology lab. All patients demonstrated acceptable R waves for diagnostic evaluation (median = 0.85 mV, range 0.24–1.7 mV). Cardiac MRI was obtained in 7 patients following ILR placement with diagnostic image quality and no adverse events. One device was explanted 28 days after placement due to concern for possible infection. No other devices required removal or revision (median follow up duration 11 months, IQR 8–13.5). ILR placement in the left anterior axillary position can record adequate signals in pediatric patients. In addition, axillary ILR device position may allow for completion of cardiac imaging, particularly cardiac MRI, without significant artifacts which is critical for patients with congenital heart disease.


Implantable loop recorder Electrophysiology Congenital heart disease Cardiac imaging MRI 



Implantable loop recorder


Transthoracic echocardiography


Magnetic resonance imaging


Institutional review board


Operating room




Compliance with Ethical Standards

Conflicts of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Pediatric Cardiology/Department of Pediatric and Adolescent MedicineMayo ClinicRochesterUSA
  2. 2.Department of Cardiovascular SurgeryMayo ClinicRochesterUSA

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