{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:34:52Z","timestamp":1790710492872,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,7,31]],"date-time":"2021-07-31T00:00:00Z","timestamp":1627689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Insertable cardiac monitors (ICMs) provide a minimally invasive method of continuous monitoring for abnormal heart rhythms. While the benefits of ICMs are clear, current algorithm performance can be improved. The objective of this study is to assess the performance of a novel adaptive atrial fibrillation (AF) detection algorithm and separately programmable atrial tachycardia (AT) algorithm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A dual\u2010stage detect\u2010and\u2010verify AF algorithm and separately programmable AT algorithm were developed. Sensitivity and PPV across a range of settings were determined in silico by comparison with an adjudicated Holter data set (<jats:italic>n<\/jats:italic>\u2009=\u20091966 with 229 patient days). Finally, the ability to improve performance through simulated remote programming was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The dual\u2010stage algorithm detected AF in all true AF patients (76\/76) resulting in a patient\u2010level sensitivity of 100%. Episode\u2010level sensitivity and PPV ranged from 97.6% to 100% and 79.1% to 98.5%, respectively. Thirty\u2010six false\u2010positive episodes were observed and 32 (88.9%) of these were corrected with programming changes. Decoupling of AF and AT durations improved PPV from a range of 10%\u201322% to a range of 95%\u2013100%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>AF and AT algorithms were designed with novel features including an adaptive morphology assessment for AF detection and separately programmable durations for AT detection. In silico performance yielded improved PPVs while maintaining high sensitivity across a range of settings. Importantly, programming changes that may be made remotely with this system reduced false positives. These algorithms allow clinicians to individualize arrhythmia detection settings thereby improving data management and reducing clinic burden.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15178","type":"journal-article","created":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T13:26:23Z","timestamp":1626441983000},"page":"2536-2543","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["A novel adaptive insertable cardiac monitor algorithm improves the detection of atrial fibrillation and atrial tachycardia in silico"],"prefix":"10.1111","volume":"32","author":[{"given":"Sunipa","family":"Saha","sequence":"first","affiliation":[{"name":"Boston Scientific Corporation St. Paul Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Perschbacher","sequence":"additional","affiliation":[{"name":"Boston Scientific Corporation St. Paul Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Jones","sequence":"additional","affiliation":[{"name":"Boston Scientific Corporation St. Paul Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1580-3493","authenticated-orcid":false,"given":"Kate","family":"Frost","sequence":"additional","affiliation":[{"name":"Boston Scientific Corporation St. Paul Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Sharma","sequence":"additional","affiliation":[{"name":"Boston Scientific Corporation St. Paul Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8003-7254","authenticated-orcid":false,"given":"Suneet","family":"Mittal","sequence":"additional","affiliation":[{"name":"Electrophysiology &amp; Cardiology The Valley Hospital Ridgewood New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Richards","sequence":"additional","affiliation":[{"name":"Cardiac Electrophysiology ProMedica Heart Institute Toledo Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,31]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.111.964809"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.1561"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euq418"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1313600"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000439063"},{"key":"e_1_2_10_7_1","first-page":"S123","article-title":"Real world specificity data from first generation of wireless insertable cardiac monitors","volume":"15","author":"Kloosterman EM","year":"2018","journal-title":"Hear Rhythm"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2020.05.027"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2019.07.015"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2016.05.010"},{"key":"e_1_2_10_11_1","first-page":"S123","article-title":"A novel algorithm to improve AF detection in implantable cardiac monitors","volume":"15","author":"Richards M","year":"2018","journal-title":"Hear Rhythm"},{"key":"e_1_2_10_12_1","first-page":"S447","article-title":"Algorithm improves detection of arrhythmias with regular RR intervals in implantable cardiac monitors","volume":"16","author":"Richards M","year":"2019","journal-title":"Hear Rhythm"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2009.02616.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12303"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.06.006"},{"key":"e_1_2_10_16_1","first-page":"S434","article-title":"Enhanced atrial fibrillation detection algorithm in insertable cardiac monitors to improve detection performance","volume":"14","author":"Sarkar S","year":"2017","journal-title":"Hear Rhythm"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13912"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2019.07.015"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2016.03.005"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.13089"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.15178","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.15178","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.15178","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T02:02:51Z","timestamp":1693360971000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.15178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,31]]},"references-count":19,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1111\/jce.15178"],"URL":"https:\/\/doi.org\/10.1111\/jce.15178","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,31]]},"assertion":[{"value":"2021-01-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-31","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}