Background:
CIED remote monitoring has rapidly evolved with automated transmission of arrhythmias and device metrics, creating overwhelming amounts of data for clinicians. Many nominal alerts are non-actionable alerts (NAA), which contributes to clinician alert fatigue. We used evidence based and guideline driven alert programming for subclinical atrial fibrillation (AF) in CIEDs, and non-sustained ventricular tachycardia (NSVT) on defibrillator platforms, to reduce NAA burden.
Methods:
CIED alerts were processed remotely using a third-party vendor with access to manufacturer specific online platforms and readonly access to the electronic health record. Daily NAAs were tallied for analysis over 6-months. Alerts were prospectively programmed off for AF episodes < 5.5 hours, persistent AF episodes > 1-month which had already generated an alert, AF episodes < 24-hours in patients with known paroxysmal AF on anticoagulation or with appendage occlusion/excision, NSVT in patients with defibrillators.