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Developements in device technology and device handling are necessary to minimize non-diagnostic interrogations.
The number of patients with non-diagnostic interrogations went from 38 to 16% (P= 0.001).
Following software upgrade, the specificity of the device improved with non-diagnostic interrogations in 16% of the patients.
Together with an only limited EGM storage capacity that led to non-diagnostic interrogations in 38% of the patients.
Besides further software developments, several measures can be discussed to reduce the number of non-diagnostic interrogations.
Our results show that using the updated algorithm the number of patients with non-diagnostic interrogations could be reduced from 38 to 16%.
To incorporate this device into routine patient care, developments in device technology and device handling are still necessary to minimize the number of non-diagnostic interrogations.
The number of patients with clinically non-diagnostic interrogations was significantly reduced [24/64 (38%) vs. 10/64 (16%); P = 0.001].
A detailed evaluation of the 10 patients with non-diagnostic interrogations despite the software upgrade revealed the following reasons of frequent AF misdetection: myopotential oversensing (n = 7), frequent PACs (n = 5), R-wave undersensing (n = 3).
Although the number of non-diagnostic interrogations was reduced after software upgrade, the lack of a gold standard for continuous AF monitoring over such extended follow-up periods prevents a conclusive assessment of diagnostic accuracy with respect to positive and negative predictive values.
With that approach, an interrogation could lead to the diagnosis: (i) no AF; (ii) definite AF; (iii) possible AF (non-diagnostic interrogation) (Table 1 ).
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