PDF(Pubmed)
Abstract：
UNASSIGNED: Implantable cardiac monitors (ICMs) provide long-term arrhythmia monitoring, but high rates of false detections increase the review burden. The new \"SmartECG\" algorithm filters false detections. Using large real-world data sets, we aimed to quantify the reduction in workload and any loss in sensitivity from this new algorithm.
UNASSIGNED: Patients with a BioMonitor IIIm and any device indication were included from three clinical projects. All subcutaneous ECGs (sECGs) transmitted via remote monitoring were classified by the algorithm as \"true\" or \"false.\" We quantified the relative reduction in workload assuming \"false\" sECGs were ignored. The remote monitoring workload from five hospitals with established remote monitoring routines was evaluated. Loss in sensitivity was estimated by testing a sample of 2000 sECGs against a clinical board of three physicians.
UNASSIGNED: Of our population of 368 patients, 42% had an indication for syncope or pre-syncope and 31% for cryptogenic stroke. Within 418.5 patient-years of follow-up, 143,096 remote monitoring transmissions contained 61,517 sECGs. SmartECG filtered 42.8% of all sECGs as \"false,\" reducing the number per patient-year from 147 to 84. In five hospitals, nine trained reviewers inspected on average 105 sECGs per working hour. This results in an annual working time per patient of 83 min without SmartECG, and 48 min with SmartECG. The loss of sensitivity is estimated as 2.6%. In the majority of cases where true arrhythmias were rejected, SmartECG classified the same type of arrhythmia as \"true\" before or within 3 days of the falsely rejected sECG.
UNASSIGNED: SmartECG increases efficiency in long-term arrhythmia monitoring using ICMs. The reduction of workload by SmartECG is meaningful and the risk of missing a relevant arrhythmia due to incorrect filtering by the algorithm is limited.
UNASSIGNED: Patients with a BioMonitor IIIm and any device indication were included from three clinical projects. All subcutaneous ECGs (sECGs) transmitted via remote monitoring were classified by the algorithm as \"true\" or \"false.\" We quantified the relative reduction in workload assuming \"false\" sECGs were ignored. The remote monitoring workload from five hospitals with established remote monitoring routines was evaluated. Loss in sensitivity was estimated by testing a sample of 2000 sECGs against a clinical board of three physicians.
UNASSIGNED: Of our population of 368 patients, 42% had an indication for syncope or pre-syncope and 31% for cryptogenic stroke. Within 418.5 patient-years of follow-up, 143,096 remote monitoring transmissions contained 61,517 sECGs. SmartECG filtered 42.8% of all sECGs as \"false,\" reducing the number per patient-year from 147 to 84. In five hospitals, nine trained reviewers inspected on average 105 sECGs per working hour. This results in an annual working time per patient of 83 min without SmartECG, and 48 min with SmartECG. The loss of sensitivity is estimated as 2.6%. In the majority of cases where true arrhythmias were rejected, SmartECG classified the same type of arrhythmia as \"true\" before or within 3 days of the falsely rejected sECG.
UNASSIGNED: SmartECG increases efficiency in long-term arrhythmia monitoring using ICMs. The reduction of workload by SmartECG is meaningful and the risk of missing a relevant arrhythmia due to incorrect filtering by the algorithm is limited.
摘要：
■植入式心脏监测仪(ICM)提供长期心律失常监测，但是高的错误检测率增加了审查负担。新的“SmartECG”算法可过滤错误检测。使用大型现实世界数据集，我们的目标是量化工作量的减少和这种新算法的任何敏感性损失。
■三个临床项目包括BioMonitorIIIm和任何器械适应症的患者。通过远程监测传输的所有皮下心电图(sECG)被算法分类为“真”或“假”。\"我们量化了工作量的相对减少，假设\"false\"sECGs被忽略。评估了五家医院已建立远程监控程序的远程监控工作量。通过针对三名医生的临床委员会测试2000个sECG的样本来估计灵敏度的损失。
■在我们的368名患者中，42%有晕厥或晕厥前期的指征，31%有隐源性卒中的指征。在418.5患者年的随访中，143,096个远程监控传输包含61,517个sECG。SmartECG将所有sECG的42.8％过滤为“假”，“将每个患者年的人数从147人减少到84人。在五家医院，9名经过培训的审查员平均每工作小时检查105个sECG。这导致每位患者在没有SmartECG的情况下的年度工作时间为83分钟，和48分钟与SmartECG。灵敏度的损失估计为2.6%。在大多数情况下，真正的心律失常被拒绝，SmartECG在错误拒绝sECG之前或之后3天内将相同类型的心律失常分类为“真实”。
■SmartECG提高了使用ICM进行长期心律失常监测的效率。SmartECG减少工作量是有意义的，并且由于算法的不正确过滤而错过相关心律失常的风险是有限的。
■三个临床项目包括BioMonitorIIIm和任何器械适应症的患者。通过远程监测传输的所有皮下心电图(sECG)被算法分类为“真”或“假”。\"我们量化了工作量的相对减少，假设\"false\"sECGs被忽略。评估了五家医院已建立远程监控程序的远程监控工作量。通过针对三名医生的临床委员会测试2000个sECG的样本来估计灵敏度的损失。
■在我们的368名患者中，42%有晕厥或晕厥前期的指征，31%有隐源性卒中的指征。在418.5患者年的随访中，143,096个远程监控传输包含61,517个sECG。SmartECG将所有sECG的42.8％过滤为“假”，“将每个患者年的人数从147人减少到84人。在五家医院，9名经过培训的审查员平均每工作小时检查105个sECG。这导致每位患者在没有SmartECG的情况下的年度工作时间为83分钟，和48分钟与SmartECG。灵敏度的损失估计为2.6%。在大多数情况下，真正的心律失常被拒绝，SmartECG在错误拒绝sECG之前或之后3天内将相同类型的心律失常分类为“真实”。
■SmartECG提高了使用ICM进行长期心律失常监测的效率。SmartECG减少工作量是有意义的，并且由于算法的不正确过滤而错过相关心律失常的风险是有限的。
