Optimizing atrial fibrillation detection: a review of subcutaneous cardiac rhythm monitors and consumer technologies

INTRODUCTION: Subcutaneous cardiac rhythm monitors (SCRMs) are utilized for prolonged continuous rhythm monitoring to evaluate for arrhythmias in the setting of infrequent palpitations, syncope, and cryptogenic stroke. Managing SCRMs requires practices to screen incoming data and adjudicate electrocardiograms (ECG) for accuracy when arrhythmias are detected. The growing utilization of SCRMs has led to increased resource demands, exacerbated by false-positive (FP) episodes and data deluge. To address this issue, manufacturers have developed advanced algorithms with some integrating artificial intelligence (AI) into their software. In parallel, providers can implement customized device settings to potentially further reduce FP alerts. AREAS COVERED: This review will cover updates in SCRMs, addressing challenges with monitoring, cost effectiveness, and contemporary consumer products. Online databases were thoroughly searched for relevant studies. EXPERT OPINION: SCRMs are a valuable tool for prolonged rhythm monitoring. Advances in algorithms are aimed to reduce data deluge by a reduction in FP episodes. Providers can also utilize customized settings to further decrease the volume of FP events. Given the costs associated with SCRMs, some patients have turned to consumer devices as a more affordable but less robust alternative. Further advancements and studies are still necessary before consumer devices can be routinely integrated into clinical practice.