B-po05-044 improved detection of atrial arrhythmias with regular r-r intervals in patients with the lux-dx insertable cardiac monitor

Insertable cardiac monitors (ICMs) detect arrhythmias like atrial fibrillation (AF) and atrial tachycardias/flutter (AT). Currently available ICM algorithms require the same episode duration setting for AF and AT. A short duration setting for AF causes false positive AT episodes due to confounding regular R-R rhythms (e.g. sinus tachycardia). However, turning AT off prevents detection of clinically relevant AT such as typical/atypical atrial flutters. Previous work (presented at HRS 2019) shows improved in silico detection of AT with regular R-R intervals by decoupling AT and AF durations. Here, we describe use of that algorithm in vivo. Describe in vivo results of an AT algorithm that allows episode detection duration to be programmed separately from that for AF. We reviewed data from patients implanted with the LUX-Dx ICM at a single center (n=40; avg 49 days/patient). All detected AT episodes were adjudicated. Algorithm performance is characterized below (Table). The AT algorithm (nominal setting: 110bpm/4 hours) was programmed to 4 hours for 24 patients and 2 hours for 16 patients; all were programmed to 110 bpm. AF episodes (534) were detected in 10 patients; AT episodes (47) were detected in 10 patients; 6 patients with AT episodes did not have detected AF episodes. The AT algorithm detected atrial flutter (AFL) in 4 patients with no detectable AF. The ability to program separately AF and AT durations enables detection of clinically relevant regular arrhythmias without compromising ideal AF detection settings. This could improve clinical data management by identifying AT without substantially increasing review burden.