Future Directions
In the future, arrhythmia-specific key EGM selection strategies may be implemented as a feature on the manufacturer’s ICM patient care network (e.g. Merlin.net), without changes at the device level. For example, clinicians may choose to streamline ICM patient management and automatically view only key EGMs by enabling the feature for individual patients contributing the most EGMs (e.g. top 25thpercentile), for subpopulations by reason for monitoring, or site-wide across the entire clinic.
In this study, EGMs were prioritized for review based only on ventricular rate and episode duration. In the future, key EGM selection may also be guided by additional metrics that may better identify TP episodes and/or more clinically actionable episodes. Examples may include episode time of day, frequency of repeated episodes, similarity to other episodes, or clinician adjudication history. Artificial intelligence may also be used to identify arrhythmia episodes that are more likely to be true.12