From fear to freedom

A diagnosis that changed everything

While out walking in the Yorkshire Dales, Peter received a life-changing call. "It was my consultant cardiologist," he recalls. "He told me that they'd picked up AF and that's most likely what had caused my stroke. He sent me a prescription to switch my medication immediately, reducing my risk of another stroke."

The device, that had been monitoring Peter’s heart for over a year, had finally detected what other tests had missed. For Peter, that was the turning point.

NICE guidance: accelerating access to life-saving technology

NICE has published healthtech guidance on implantable cardiac monitors to detect AF after cryptogenic stroke. It recommends Reveal LINQ for patients whose stroke is suspected to have been caused by a heart rhythm problem, where non-invasive monitoring has failed to detect AF.

Peter recognises the importance of this recommendation: "NICE approval is so important. It helps more hospitals adopt the technology sooner, and that's got to benefit patients."

A developer's perspective

Lisa Jones, product manager for cardiovascular diagnostics at Medtronic, the company behind Reveal LINQ, worked closely with NICE throughout the evaluation process. “I've got the highest regard for NICE," she says. "The team was genuinely open-minded and collaborative."

At Medtronic, there's a clear appreciation for NICE's role. "We fully support the work of NICE to improve outcomes in health and social care and appreciate the value NICE evaluations offer to those using our devices and therapies," Lisa explains. "NICE is such a big part of what the NHS listens to. It was fantastic to have NICE guidance for our product saying this is the right thing to do."

For Lisa, a positive NICE evaluation helps facilitate a consistent approach to adoption across the NHS. "NHS trusts often find it challenging to assess the range of new health technologies available," she acknowledges. "A positive recommendation from NICE, affirming a product's clinical and cost effectiveness, is so valuable."

Since our guidance was published, more hospitals have begun using Reveal LINQ for eligible patients. Many centres that were already providing this service to their stroke patients were also able to formalise their pathways in line with NICE guidance.

Following guidance publication, The National Hospital for Neurology and Neurosurgery, part of University College London Hospitals NHS Foundation Trust, became the first stroke centre in the UK to introduce nurse-led implantation of an insertable cardiac monitor for AF detection within a stroke service.

Specialist stroke nurses in the department are now implanting the Reveal LINQ device, enabling patients to remain under the care of the stroke team rather than being referred to cardiology. This approach improves continuity of care, allows patients to be managed by familiar clinicians, and significantly reduces the time to device implantation and AF detection.

"The first patient to have their cardiac monitor fitted in this way was delighted," Lisa concludes. "This development most likely would not have happened if it was not for the backing of NICE."

Selina Edwards, stroke nurse practitioner at the trust said: “As a nurse, it is incredibly rewarding to be able to carry out the procedure in a timely way so our patients can feel reassured that that their heart rhythm is being continuously monitored. As soon as an abnormal rhythm is detected, we can start appropriate treatment quickly to help prevent further strokes.”

For NHS decision makers: If you’re considering healthtech solutions for your trust or integrated care board, explore NICE's healthtech guidance to understand how evidence-based recommendations can support confident commissioning decisions.

For healthtech developers: If you have a promising technology that aligns with NHS needs and you are seeking to scale use across the NHS, discover how NICE's healthtech guidance can support your innovation journey.