Exploring Optimal Cardiac Electronic Implantable Devices Programming: Reducing Non-Actionable Alerts and Assessing...

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Device Technology

Background:

• Cardiac implantable electronic devices (CIEDs) generate increasing remote data.
• Excessive non-actionable alerts (NAAs) lead to alert fatigue among clinicians.
• There is a need to optimize CIED alert parameters.

Purpose of the Study:

• To minimize NAAs by optimizing CIED alert parameters.
• To evaluate the impact of optimized alert parameters on clinical outcomes.
• To reduce alert fatigue in patients with CIEDs.

Main Methods:

• 536 participants with CIEDs were included.
• 413 patients had CIEDs reprogrammed to censor specific atrial fibrillation (AF) and non-sustained ventricular tachycardia (NSVT) alerts.
• NAAs were tracked pre- and post-reprogramming; ischemic stroke and sudden cardiac death (SCD) were assessed over follow-up.

Main Results:

• Reprogramming significantly decreased NAAs (p < 0.001).
• Ischemic stroke rates were similar between reprogrammed and control groups for AF alerts.
• Sudden cardiac death incidence was lower in reprogrammed patients with NSVT alerts compared to controls.

Conclusions:

• Guideline-based CIED alert parameter optimization significantly reduced NAA burden.
• This approach did not increase adverse outcomes (stroke, SCD) in patients with device-detected AF or NSVT.
• Optimizing CIED alerts can safely reduce data noise and improve clinical efficiency.