Therapies and procedures

Atrial fibrillation management

Learn more about how our portfolio can help you detect, reduce, and respond to atrial fibrillation (AF), and treat paroxysmal AF in your patients.

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The Medtronic AF advantages across our portfolio

  • Increase the accurate and timely diagnosis of AF.1
  • Improve AF patient outcomes.2-5
  • May reduce AF-related utilization of healthcare resources.3,6
  • Use the LINQ™ family of ICMs (Reveal LINQ™ ICM and LINQ II™ ICM) to make data-guided management decisions such as medical management, including anticoagulation.7-10

Detect AF

Timely and accurate AF detection and monitoring through device-based algorithms.

LINQ family of ICMs 

LINQ ICMs provide data that enables clinicians to objectively diagnose and monitor both asymptomatic and symptomatic AF.11

This data results in the measure of true AF burden and enables data-driven decisions, including those related to medications and treatments such as anticoagulants or ablation.7-10

Cobalt™ XT VR ICD
Cobalt™ VR ICD

Using the TruAF detection algorithm, Medtronic single chamber ICDs are the only ICDs that can detect AF with a traditional lead.

  • 34% of patients had AF detected at six months.15

Watch as Dr. Alan Cheng discusses the importance of AF detection in a single chamber ICD.

Dr. Alan Cheng AF detection video - (01:42)

Watch as Dr. Alan Cheng discusses the importance of atrial fibrillation (AF) detection in a single chamber implantable cardioverter defibrillator (ICD).
More information (see more) Less information (see less)

Reduce AF

Exclusive algorithms demonstrated to reduce the risk and duration of AF.

Managed Ventricular Pacing (MVP™)

Reduces unnecessary RV pacing by 99%.16

  • Every 1% of unnecessary RV pacing is accompanied by a 1% greater AF risk17

Reactive ATP™ algorithm

Reduces the duration of AT/AF.18

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

AdaptivCRT™ algorithm

46% reduction in AF risk.19

The Reactive ATP (rATP) algorithm delivers atrial antitachycardia pacing (ATP) to terminate an ongoing AF episode after a programmed interval, or when the rhythm organizes and/or slows. Recent evidence shows rATP reduces the likelihood of patients experiencing AT/AF.18 Learn more in this informative video as CRHF Chief Medical Officer, Dr. Rob Kowal, discusses the data.

Nearly 20 years of research and physician collaboration resulted in cardiac device algorithm innovations that help manage AF.

Watch Dr. Amin Al-Ahmad walk through this history and discuss the AdaptivCRT algorithm, which reduces AF risk,19 and the Reactive ATP algorithm, which reduces AF duration.18

To view the full webcast, visit medtronicacademy.com/globalgrandrounds.

Respond to AF

Exclusive feature to improve effective CRT delivery in the presence of AF.

EffectivCRT™ during AF algorithm

Up to 16% increase in effective CRT delivery20

The AdaptivCRT algorithm optimizes CRT pacing every minute whether AV conduction is normal, prolonged, or blocked. The EffectivCRT during AF algorithm automatically changes the pacing rate to increase effective CRT delivery during AF by up to 16%.20

Dive deeper with Ruth Klepfer, senior research manager, as she explains how these two CRT algorithms work together to help manage AF in this short video.

Treat AF

Restore life's rhythm by unlocking potential through novel and efficient technology built on unmatched experience​. 

Arctic Front™ family of cryoballoons

The only catheters approved for initial rhythm control treatment as an alternative to anti-arrhythmic medications.21

A safe and effective tool for early rhythm control that has been used to treat over one million patients worldwide.22

The Arctic Front family of cryoballoons has proven shorter, more predictable procedure times, enabling the lab to benefit from less overtime, block schedule consistency,23,24 increased staff satisfaction,25 and more.

DiamondTemp™ ablation system

The only open-irrigated RF catheter with industrial diamonds to optimize power based on direct tissue surface temperature measurement. DiamondTemp is a safe and effective tool to treat AF patients.

Compared to contact force-RF, the DiamondTemp ablation system demonstrated26:

  • 40% reduction in RF time
  • 55% reduction in individual RF ablation duration
  • 58% reduction in saline infusion

Long-term cardiac monitoring

Continued cardiac monitoring after an AF ablation with the Medtronic LINQ family of ICMs provides comprehensive data including AF burden, activity level, and heart rate variability. This data may be used by physicians to guide AF management decisions, including the use of anticoagulation.7-10 Insertable cardiac monitors remain the gold standard for the detection of AF recurrence and quantification of AF burden.*27

*Compared to intermittent monitoring.

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References

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

Passman R, Leong-Sit P, Andrei AC, et al. Targeted Anticoagulation for Atrial Fibrillation Guided by Continuous Rhythm Assessment With an Insertable Cardiac Monitor: The Rhythm Evaluation for Anticoagulation With Continuous Monitoring (REACT.COM) Pilot Study. J Cardiovasc Electrophysiol. March 2016;27(3):264-270.

8

Zuern CS, Kilias A, Berlitz P, et al. Anticoagulation after Catheter Ablation of Atrial Fibrillation Guided by Implantable Cardiac Monitors. Pacing Clin Electrophysiol. June 2015;38(6):688-693.

9

Mascarenhas DAN, Farooq MU, Ziegler PD, Kantharia BK. Role of insertable cardiac monitors in anticoagulation therapy in patients with atrial fibrillation at high risk of bleeding. Europace. June 2016;(18)6):799-806.

10

Pothineni NVK, Amankwah N, Santangeli P, et al. Continuous rhythm monitoring-guided anticoagulation after atrial fibrillation ablation. J Cardiovasc Electrophysiol. February 2021;32(2):345-353.

11

Witkowski M, Bissinger A, Grycewicz T, Lubinski A. Asymptomatic atrial fibrillation in patients with atrial fibrillation and implanted pacemaker. Int J Cardiol. January 15, 2017;227:583-588.

12

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.

13

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

14

 QADoc DSN026170, Version 2.0, AT/AF Duration Performance Comparison. Medtronic data on file.

15

Boriani G, Deshmukh A, Brown ML, Koehler J, Friedman PA. Understanding the incidence of AF in single-chamber ICD patients: a real-world analysis. EP Europace. June 2017;19(3):154.

16

Chen S, Chen K, Tao Q, et al. Reduction of unnecessary right ventricular pacing by managed ventricular pacing and search AV+ algorithms in pacemaker patients: 12-month follow-up results of a randomized study. Europace. November 2014;16(11):1595-1602.

17

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.

18

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.

19

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.

20

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.

21

Wazni OM, Dandamudi G, Sood N, et al. Cryoballoon Ablation as Initial Therapy for Atrial Fibrillation. N Engl J Med. January 28, 2021;384(4):316-324.

22

Medtronic data on file.

23

Kowalski M, Su WW, Holbrook R, et al. Impact of Cryoballoon Ablation on Electrophysiology Lab Efficiency During the Treatment of Patients with Persistent Atrial Fibrillation: A Sub-Analysis of the STOP Persistent AF Study. J Invasive Cardiol. July 2021;33(7):E522-E530.

24

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.

25

Lieberman Inc. Blinded Market Research Survey. Medtronic data on file. February 2018.

26

Kautzner J, Albenque JP, Natale A, et al. A Novel Temperature-Controlled Radiofrequency Catheter Ablation System Used to Treat Patients With Paroxysmal Atrial Fibrillation. JACC Clin Electrophysiol. Published online January 27, 2021.

27

Aguilar M, Macie L, Deyell MW, et al. The Influence of Monitoring Strategy on Assessment of Ablation Success and Post-Ablation Atrial Fibrillation Burden Assessment: Implications for Practice and Clinical Trial Design. Circulation. January 4, 2022;145(1):21-30.