Key result
Trigger-based ICM setting adjustments are linked to fewer false-positive bradycardia and AF alerts.
Why the study?
No studies have investigated whether optimizing implantable cardiac monitor programming can reduce false-positive alerts.
Does optimizing implantable cardiac monitor programming reduce false-positive arrhythmia alerts in patients with frequent false-positive alerts?
Observational (n=8)
Does optimizing implantable cardiac monitor programming reduce false-positive arrhythmia alerts in patients with frequent false-positive alerts?
Adjusting nominal settings on implantable cardiac monitors based on trigger mechanisms can effectively reduce false-positive arrhythmia alerts.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for tailored ICM programming to cut false alerts; prospective validation needed before clinical adoption.
No studies have investigated whether optimizing implantable cardiac monitors (ICM) programming can reduce false-positive (FP) alerts. We identified patients implanted with an ICM (BIOMONITOR III) who had more than 10 FP alerts in a 1-month retrospective period. Uniform adjustments of settings were performed based on the mechanism of FP triggers and assessed at 1 month. Eight patients (mean age 57.5 ± 23.2 years; 37% female) were enrolled. In 4 patients, FPs were caused by undersensing of low-amplitude premature ventricular contractions (PVCs). No further false bradycardia was observed with a more aggressive decay of the dynamic sensing threshold. Furthermore, false atrial fibrillation (AF) alerts decreased in 2 of 3 patients. Two patients had undersensing of R waves after high-amplitude PVCs; false bradycardia episodes disappeared or were significantly reduced by limiting the initial value of the sensing threshold. Finally, the presence of atrial ectopic activity or irregular sinus rhythm generated false alerts of AF in 2 patients that were reduced by increasing the R-R variability limit and the confirmation time. In conclusion, adjustments to nominal settings can reduce the number of FP episodes in ICM patients. More research is needed to provide practical recommendations and assess the value of extended ICM programmability.
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Guarracini et al. (2022) conducted an observational in Implantable cardiac monitor with false-positive arrhythmia alerts (n=8). Optimization of implantable cardiac monitor programming vs. Baseline (retrospective 1-month period) was evaluated on Reduction in false-positive arrhythmia alerts. Adjusting nominal implantable cardiac monitor settings based on trigger mechanisms successfully reduced false-positive bradycardia and atrial fibrillation alerts in a cohort of 8 patients.
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