Real-world experience with insertable cardiac monitor in the pediatric population: insights from a single center

Background

The Insertable Cardiac Monitor (ICM) plays a key role in the diagnosis of cardiac arrhythmias. Recent technological advances have significantly reduced the size of these devices, making them more suitable also for pediatric patients. However, dedicated studies and data on their use in children and adolescents remain limited.

Purpose

To describe a single-center experience with LUX-Dx ICM implantation in pediatric and adolescent patients, and to assess patient and caregiver experience during follow-up.

Methods

The LUX-Dx was implanted as an injectable system. After implantation, patients or caregivers were provided by the myLUX Patient App connected to the ICM for remote monitoring and daily or on-demand data transmission. Procedural characteristics, operator feedback, and patient experience were evaluated.

Results

Twenty-nine consecutive LUX-Dx implantations were performed between July 2023 and September 2025 (55% female; median age 12 [7–15] years). The most frequent indications for ICM implantation were syncope (24%), Brugada syndrome (24%), and atrioventricular conduction disorders. (24%). All procedures were performed in the EP laboratory by experienced electrophysiologists. Most implantations were performed under general anesthesia (90%) without systemic or local antibiotics. Surface ECG mapping was performed before 23 (80%) procedures. All devices were implanted in the left parasternal region with a 45° orientation, except one precordial case. During implantation one (3%) system revision was required due to inadequate sensing; no other complications occurred. Median procedure time was 6 min [5–7]. Mean R-wave amplitude was 0.74 ± 0.33 mV at implant and 0.74 ± 0.34 mV at discharge; The P-wave visibility, i.e., the ratio between the number of clearly identifiable P-waves and the number of heart cycles during 10 sec ECG with a regular 1:1 conduction, was 100% at implantation and remained stable also at discharge. Operator feedback was uniformly positive: all respondents rated the implantation tools as either good (76%) or excellent (24%), and the remote management system as good (52%) or excellent (48%). Patient experience was excellent: 97% reported no pain during implantation; no paresthesia or pain was reported after implantation or at discharge.

A follow-up survey (≥3 months post-implant) was completed by 15 patients/caregivers (52%). During a median follow-up of 4 months [3–18] no major technical issues occurred. Two patients (13%) experienced temporary connection losses, easily resolved after contacting the hospital. The myLUX Patient App was mainly used by caregivers and was rated positively by all users (Figure 1). All patients reported feeling reassured by remote monitoring.

Conclusions

LUX-Dx ICM implantation in pediatric patients was safe, efficient, and well tolerated. The system provided stable signal quality, reliable sensing, and high user satisfaction, with minimal technical issues during follow-up.myLUX Patient App feedbacks