Insertable Cardiac Monitoring in Pediatric Patients: A Real‐World Single‐Center Experience With a New‐Generation Device

BACKGROUND: Insertable cardiac monitors (ICMs) are increasingly used in pediatric patients, yet data on new-generation devices remain limited. The aim of this retrospective study was to describe a single-center real-world experience with a new-generation ICM in pediatric patients, focusing on procedural feasibility, sensing performance, transmission burden, and user experience. METHODS: Consecutive patients aged ≤18 years undergoing LUX-Dx ICM implantation between 2023 and 2025 were included. Procedural characteristics, sensing parameters, transmission patterns, diagnostic yield, reprogramming strategies, and patient/caregiver-reported experience were analyzed. Data are reported as median (25th-75th percentile) or mean ± standard deviation. RESULTS: Twenty-nine patients underwent ICM implantation. Procedures were brief (6 ± 2 min) and complication-free. Electrical parameters were satisfactory and stable at discharge. Follow-up was 18 (6-23) months. A median of 2.7 transmissions per patient-month were received, of which 55% were alerts. Time from arrhythmia detection to transmission was 15 (3-21) hours. The number of episodes per patient was 4.8 (3.1-15.9) per month, with substantial inter-patient variability and bradycardia being the most frequent detection (80%). A diagnostic conclusion was reached in 79% of patients (positive: 45%, negative: 34%) at a median of 3 months. Reprogramming was performed in 90% of patients, mainly remotely (77%), and was predominantly directed toward reducing detection sensitivity. Patient and caregiver acceptance of remote monitoring was high. CONCLUSIONS: In pediatric patients, new-generation ICM implantation was safe, well tolerated, and associated with stable sensing performance. Remote monitoring and reprogramming enabled timely diagnosis and individualized optimization, supporting the clinical utility of contemporary ICMs in this population.