Programming Optimization in Implantable Cardiac Monitors to Reduce False-Positive Arrhythmia Alerts: A Call for Research

Diagnostics

卷:12

Francesco Triglione¹  Daniele Giacopelli¹  Silvia Quintarelli²  Marta Martin²  Alessio Coser²  Roberto Bonmassari²  Fabrizio Guarracini²  Massimiliano Marini²  Martina Testolina³ 

[1] Clinical Unit, Biotronik Italia, Vimodrone, 20090 Milano, Italy;

[2] Department of Cardiology, S. Chiara Hospital, 38122 Trento, Italy;

[3] ULSS 6 Euganea, Camposampiero, 35012 Padova, Italy;

关键词: cardiac arrhythmias;    implantable cardiac monitor;    implantable loop recorder;    oversensing;    remote monitoring;    undersensing;   

DOI  :  10.3390/diagnostics12040994

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown