THE MEDTRONIC AF ADVANTAGEs ACROSS OUR PORTFOLIO

  • Increase the accurate and timely diagnosis of atrial fibrillation (AF)1
  • Improve AF patient outcomes2-5
  • May reduce AF-related utilization of healthcare resources3,6

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DETECT

Reveal LINQ™ ICM
The world's smallest, most accurate ICM1,7

  • 8x fewer AF false positives than other app-based ICMs1,7

Up to 3-year longevity for long-term monitoring

  • 30% of cryptogenic stroke AF diagnoses occur after 2 years8
  • 40% of high-risk patients had AF at 30 months9

 

Azure™ XT DR MRI pacemaker,
Evera MRI™ DR ICD

Claria MRI™ CRT-D, and
Percepta™ Quad CRT-P MRI
95-96% AT/AF episode PPV10-12

Visia AF MRI™ VR ICD
The only single chamber ICD that detects AF using the TruAF™ Detection Algorithm and a traditional lead

  • 34% of patients had AF detected at 6 months13
Image showing the implantable cardiac rhythm devices that detect AF, including ICDs, CRT-Ds, CRT-Ps, and dual-chamber pacemakers

REDUCE

Managed Ventricular Pacing (MVPTM) reduces unnecessary RV pacing by 99%.14

  • Every 1% of unnecessary RV pacing is accompanied by a 1% greater AF risk.15

Reactive ATP™ Algorithm reduces the duration of AT/AF16:

  • ≥ 1 day by 19%
  • ≥ 7 days by 36%
  • ≥ 30 days by 44%

AdaptivCRT™ Algorithm
46% reduction in AF risk17

Image showing the implantable cardiac rhythm devices that reduce the risk and/or duration of AF, including dual-chamber pacemakers and ICDS, as well as CRT-Ds and CRT-Ps

RESPOND

EffectivCRT During AF Algorithm
Up to 16% increase in effective CRT delivery18

Images of a CRT-D and CRT-P devices that respond to AF

TREAT 

With more than 12 years of clinical experience, a half-million procedures performed in over 60 countries, and more than 700 peer-reviewed articles,19  momentum is building for the Arctic Front family of cryoballoons — the safe2 and consistent4 way to treat paroxysmal AF (PAF).

Arctic Front Advance™ Cryoballoon
68.1% freedom from AF at 36 months20

Relative to radiofrequency, cryoballoon demonstrated:

  • 34% fewer cardiovascular hospitalizations5
  • 33% fewer repeat ablations5

The cryoballoon is indicated for the treatment of drug refractory, recurrent, symptomatic paroxysmal AF.

Procedures are 28-96 minutes faster than point-by-point RF,21-30 creating time for additional procedures in the EP lab.31

Images of a CRT-D and CRT-P devices that respond to AF
1

Pürerfellner H, Sanders P, Sarkar S, et al. Adapting detection sensitivity based on evidence of irregular sinus arrhythmia to improve atrial fibrillation detection in insertable cardiac monitors. Europace. November 1, 2018;20(FI_3):f321-f328.

2

Packer DL, Kowal RC, Wheelan KR, et al. Cryoballoon ablation of pulmonary veins for paroxysmal atrial fibrillation: first results of the North American Arctic Front (STOP AF) pivotal trial. J Am Coll Cardiol. April 23, 2013;61(16):1713-1723.

3

Boriani G, Manolis AS, Tukkie R, et al. Effects of enhanced pacing modalities on health care resource utilization and costs in bradycardia patients: An analysis of the randomized MINERVA trial. Heart Rhythm. June 2015;12(6):1192-1200.

4

Kuck KH, Brugada J, Fürnkranz A, et al. Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation. N Engl J Med. June 9, 2016;374(23):2235-2245.

5

Kuck KH, Fürnkranz A, Chun KR, et al. Cryoballoon or radiofrequency ablation for symptomatic paroxysmal atrial fibrillation: reintervention, rehospitalization, and quality-of-life outcomes in the FIRE AND ICE trial. Eur Heart J. October 7, 2016;37(38):2858-2865.

6

Chun KRJ, Brugada J, Elvan A, et al. The Impact of Cryoballoon Versus Radiofrequency Ablation for Paroxysmal Atrial Fibrillation on Healthcare Utilization and Costs: An Economic Analysis From the FIRE AND ICE Trial. J Am Heart Assoc. July 27, 2017;6(8).

7

Nölker G, Mayer J, Boldt LH, et al. Performance of an Implantable Cardiac Monitor to Detect Atrial Fibrillation: Results of the DETECT AF Study. J Cardiovasc Electrophysiol. December 2016;27(12):1403-1410.

8

Sanna T, Diener HC, Passman RS, et al. Cryptogenic stroke and underlying atrial fibrillation. N Engl J Med. June 26, 2014;370(26):2478-2486.

9

Reiffel JA, Verma A, Kowey PR, et al. Incidence of Previously Undiagnosed Atrial Fibrillation Using Insertable Cardiac Monitors in a High-Risk Population: The REVEAL AF Study. JAMA Cardiol. October 1, 2017;2(10):1120-1127.

10

Pürerfellner H, Gillis AM, Holbrook R, Hettrick DA. Accuracy of Atrial Tachyarrhythmia Detection in Implantable Devices with Arrhythmia Therapies. Pacing Clin Electrophysiol. July 2004;27:983-992.

11

Ziegler PD, et al. Accuracy of Atrial Fibrillation Detection in Implantable Pacemakers. Presented at HRS 2013 (PO02-08).

12

Medtronic Data on File. QADoc DSN026170, Version 2.0, “AT/AF Duration Performance Comparison.”

13

Boriani G, et al. Understanding the incidence of AF in single-chamber ICD patients: a real-world analysis. Presented at Europace 2017.

14

Gillis AM, Pürerfellner H, Israel CW, et al. Reduction of unnecessary right ventricular pacing due to the managed ventricular pacing (MVP) mode in patients with symptomatic bradycardia. Benefit for both sinus node disease and AV block indications. Presented at HRS 2005 (Abstract AB21-1).

15

Sweeney MO, Hellkamp AS, Ellenbogen KA, et al. Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction. Circulation. June 17, 2003;107(23):2932-2937.

16

Crossley GH, Padeletti L, Zweibel S, Hudnall JH, Zhang Y, Boriani G. Reactive atrial-based antitachycardia pacing therapy reduces atrial tachyarrhythmias. Pacing Clin Electrophysiol. July 2019;42(7):970-979.

17

Birnie D, Hudnall H, Lemke B, et al. Continuous optimization of cardiac resynchronization therapy reduces atrial fibrillation in heart failure patients: Results of the Adaptive Cardiac Resynchronization Therapy Trial. Heart Rhythm. December 2017;14(12):1820-1825.

18

Plummer CJ, Frank CM, Bári Z, et al. A novel algorithm increases the delivery of effective cardiac resynchronization therapy during atrial fibrillation: The CRTee randomized crossover trial. Heart Rhythm. March 2018;15(3):369-375.

19

Medtronic data on file.

20

Knight BP, Novak PG, Sangrigoli R, et al. Long-Term Outcomes After Ablation for Paroxysmal Atrial Fibrillation Using the Second-Generation Cryoballoon: Final Results From STOP AF Post-Approval Study. JACC Clin Electrophysiol. March 2019;5(3):306-314.

21

DeVille JB, Svinarich JT, Dan D, et al. Comparison of resource utilization of pulmonary vein isolation: cryoablation versus RF ablation with three-dimensional mapping in the Value PVI Study. J Invasive Cardiol. June 2014;26(6):268-272.

22

Aryana A, Singh SM, Kowalski M, et al. Acute and Long-Term Outcomes of Catheter Ablation of Atrial Fibrillation Using the Second-Generation Cryoballoon versus Open-Irrigated Radiofrequency: A Multicenter Experience. J Cardiovasc Electrophysiol. August 2015;26(8): 832-839.

23

Cheng X, Hu Q, Zhou C, et al. The long-term efficacy of cryoballoon vs irrigated radiofrequency ablation for the treatment of atrial fibrillation: A meta-analysis. Int J Cardiol. February 15, 2015;181:297-302.

24

Giovanni GD, Wauters K, Chierchia GB, et al. One-year follow-up after single procedure Cryoballoon ablation: a comparison between the first and second generation balloon. J Cardiovasc Electrophysiol. August 2014; 25(8):834-839.

25

Casado-Arroyo R, Chierchia GB, Conte G, et al. Phrenic nerve paralysis during cryoballoon ablation for atrial fibrillation: a comparison between the first- and second-generation balloon. Heart Rhythm. September 2013;10(9):1318-1324.

26

Fürnkranz A, Bordignon S, Schmidt B, et al. Improved procedural efficacy of pulmonary vein isolation using the novel second-generation cryoballoon. J Cardiovasc Electrophysiol. May 2013;24(5):492-497.

27

Fürnkranz A, Bordignon S, Dugo D, et al. Improved 1-year clinical success rate of pulmonary vein isolation with the second-generation cryoballoon in patients with paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol. August 2014;25(8):840-844.

28

Martins RP, Hamon D, Césari O, et al. Safety and efficacy of a second-generation cryoballoon in the ablation of paroxysmal atrial fibrillation. Heart Rhythm. March 2014;11(3):386-393.

29

Straube F, Dorwarth U, Schmidt M, Wankerl M, Ebersberger U, Hoffman E. Comparison of the first and second cryoballoon: high-volume single-center safety and efficacy analysis. Circ Arrhythm Electrophysiol. April 2014;7(2):293-299.

30

Straube F, Dorwarth U, Vogt J, et al. Differences of two cryoballoon generations: insights from the prospective multicentre, multinational FREEZE Cohort Substudy. Europace. October 2014;16(10):1434-1442.

31

Kowalski M, DeVille JB, Svinarich JT, et al. Using Discrete Event Simulation to Model the Economic Value of Shorter Procedure Times on EP Lab Efficiency in the VALUE PVI Study. J Invasive Cardiol. May 2016;28(5):176-182.