ID: 4312247 MODELING PEDIATRIC LONG QT SYNDROME DIAGNOSIS AND ARRHYTHMIA RISK USING HOLTER MONITOR DATA

Background: ABRM is an emerging alternative to conventional scheduled RM, relying on alert-initiated CIED transmissions and continuous patient connectivity.This model reduces burden on clinicians and Allied Health Professionals (AHPs) by limiting reviews to clinically actionable reports.Software may enable ABRM by prioritizing transmissions and maintaining connectivity.Objective: Evaluate how software impacts (1) transmission burden across RM models, clinics, and devices; and (2) continuous connectivity via automated outreach.Methods: Two retrospective analyses were conducted via Vector Platform software (7/2023-7/2024).Study 1 evaluated 338,601 transmissions from 24 CIED (avg 1,115 pts) and 23 HF (avg 109 pts) clinics across three RM models:(1) software only, (2) software + AHP review, and (3) software + AHP review + ABRM.Transmissions were classified as actionable or non-actionable and scheduled or unscheduled; paired t-tests compared volumes.Study 2 examined 117 disconnected patients receiving automated outreach; a chi-square test assessed connectivity differences by device type. Results:In Study 1, non-actionable transmissions fell from 53.1% (software only) to 33.8% (+AHP) to 0% (+ABRM) (Table 1).Notably, 6% (20,349/338,601) of transmissions were both actionable and scheduled.In Study 2, 65.8% of patients were continuously connected.Automated outreach resolved 41.5% of disconnections within 2 days and 100% within 65 days (Figure 1), with no device-type differences (p50.119).Conclusion: Software with AHP review and ABRM significantly reduced review burden by 85.4% across clinics and devices.Additionally, automated outreach efficiently reconnected patients, supporting continuous connectivity.As 6% of actionable reports were tied to scheduled transmissions, future improvements to enable ABRM should address device behaviors that delay alert delivery until scheduled intervals.Findings support software-enabled, scalable RM aligned with value-based care.