Real-world use of insertable cardiac monitor remote programming: A multicenter European experience

Insertable cardiac monitors (ICMs) enable continuous arrhythmia monitoring but generate high transmission volumes, increasing clinical workload. The LUX-Dx ICM (Boston Scientific) allows remote reprogramming of device alert settings, potentially reducing in-office visits.

This study aimed to evaluate the real-world use of remote reprogramming after its initial commercialization in Europe and its impact on transmission burden.

Deidentified data were collected from 697 consecutive patients across 23 European centers between 2022 and 2024.

Syncope (48%) was the most frequent indication for ICM implantation. Patients were followed for a median of 9 months (25th-75th percentile 4-13). A total of 401 reprogramming events (0.8 per patient-year) occurred in 230 ICMs, with 38% (95% confidence interval 34-43) of devices reprogrammed within 1 year. Of these, 156 (39%) were performed remotely. The overall transmission rate was 3.0 per patient-month (95% confidence interval 2.9-3.1): alert transmissions (64%), scheduled transmissions (31%), patient-initiated interrogations (4%), and clinician-initiated interrogations (1%). The rate of recorded episodes varied significantly by indication (P < .001), with bradycardia the most frequent across groups. Reprogramming significantly reduced transmission rates (median 57%; 25th-75th percentile 4-86), alerts (78%; 25th-75th percentile 11-96), and recorded episodes (91%; 25th-75th percentile 47-99) (all P < .001).

ICM reprogramming plays a key role in optimizing device performance and reducing remote monitoring burden. Currently used in 39% of cases, remote reprogramming holds potential for broader adoption to minimize in-office visits. Efficiency may be further improved by transitioning to an alert-based monitoring strategy and eliminating scheduled transmissions.