ArticlePacing and clinical electrophysiology : PACE2025
Algorithm Improvements in an Insertable Cardiac Monitor Reduce False Positives and Episode Review Burden.
Article in Pacing and clinical electrophysiology : PACE, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Algorithm Improvements in an Insertable Cardiac Monitor Reduce False Positives and Episode Review Burden.Pacing and clinical electrophysiology : PACE · 2025Article
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8 authors.
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Abstract
introductionThe use of insertable cardiac monitors (ICM) for arrhythmia monitoring continues to grow steadily. However, ICM performance remains less than perfect, and the volume of transmitted data poses a challenge to clinics. Here, we evaluate the impact of three improvements implemented in the LUX-Dx II+ ICM for atrial fibrillation (AF), pause, and bradycardia detection.
methodsEnhanced AF and pause algorithms were evaluated using real-world ECG data and compared against the predecessor LUX-Dx algorithms. Optimized nighttime (11 p.m.-7 a.m.) programming settings were simulated on LUX-Dx data to evaluate the reduction of non-actionable nocturnal bradycardia (>30 bpm) and pause (<5 s) detections.
resultsThe novel AF algorithm reduced false positives by 34% in the training dataset and 38% in the test dataset while maintaining >98% sensitivity relative to the legacy algorithm. False positive reduction and relative sensitivity were even higher (74% and 100%, respectively) in a subset of patients with more sensitive AF programming settings. The enhanced pause algorithm reduced false positives by 62.5% in the training set and 48.6% in the test set, while maintaining 100% relative sensitivity. Application of adjusted nocturnal detection thresholds reduced the number of nighttime bradycardia and pause episodes by 98% and 90%, corresponding to an overall episode reduction of 75% and 56%, respectively.
conclusionThe enhanced ICM algorithms and programming settings substantially reduced false positive AF and pause detections as well as non-actionable nighttime bradycardia and pause detections. These enhancements are expected to improve ICM performance and workflow in the device clinic.
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