Reducing the electrogram review burden imposed by insertable cardiac monitors

Area of Science:

• Cardiology
• Biomedical Engineering
• Health Informatics

Background:

• Insertable cardiac monitors (ICMs) are crucial for diagnosing arrhythmias remotely.
• Manual review of electrograms (EGMs) from ICMs is time-consuming and labor-intensive.
• Efficient data triage is needed to optimize arrhythmia diagnosis.

Purpose of the Study:

• To assess the clinical impact of prioritizing key electrograms (EGMs) for review.
• To determine if a focused EGM review strategy affects diagnostic timelines.

Main Methods:

• Retrospective analysis of Abbott Confirm Rx™ ICM data with over 90 days of transmission.
• EGMs were adjudicated as true or false positives (TP, FP).
• Key EGMs were selected based on arrhythmia type, ventricular rate, and episode duration, with up to 3 per day.

Main Results:

• Key EGM selection reduced the overall EGM review burden by 55%.
• True positive (TP) days were minimally reduced (0.0-2.1%) across arrhythmia types.
• 99% of patients with true arrhythmias received a diagnosis on the same day as with full EGM review.

Conclusions:

• Prioritizing key EGMs substantially decreases the review burden.
• This strategy accelerates clinical workflow without compromising diagnostic timelines for arrhythmias.
• Implementation in patient care networks can improve efficiency for ICM data analysis.