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