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Challenges in Clinical Electrocardiography
August 24, 2020

The Weak LINQ—Continuous Rhythm Monitoring During Sudden Death

Author Affiliations
  • 1School of Medicine, University of California, San Francisco
  • 2Department of Medicine, University of California, San Francisco
  • 3Cardiac Electrophysiology Section, Division of Cardiology, Department of Medicine, University of California, San Francisco
JAMA Intern Med. Published online August 24, 2020. doi:10.1001/jamainternmed.2020.2630

A person in their 70s was found unconscious and unresponsive. They had a history of hypertension, dyslipidemia, atrial fibrillation, seizure disorder, and coronary artery disease (CAD). A LINQ (Medtronic) implantable loop recorder (ILR) had been placed 6 months earlier for workup of syncope. Medications included amitriptyline, aspirin, atorvastatin, hydrocodone, lisinopril, pantoprazole, and rivaroxaban. Emergency medical services discovered the patient in asystole. The patient was pronounced dead on scene with an emergency medical services primary impression of out-of-hospital cardiac arrest. The patient had last been seen in their usual state of health 3 hours prior; thus, the presentation met World Health Organization (WHO) criteria for sudden cardiac death (SCD).1

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