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Title: | Ability to remotely monitor atrial high-rate episodes using a single-chamber implantable cardioverter-defibrillator with a floating atrial sensing dipole |
Author: | Hindricks, Gerhard Theuns, Dominic A. Bar Lev, David Anguera, Ignasi Ayala Paredes, Félix Alejandro Arnold, Martin Geller, J. Christoph Merkely, Béla Dyrda, Katia Marjolaine Perings, Christian Maglia, Giampiero Ploux, Sylvain Meyhöfer, Jürgen BlomströmcLundqvist, Carina Karjalainen, Pasi Liang, Yanchun Diemberger, Igor Wranicz, Jerzy Krzysztof Barr, Craig Quartieri, Fabio Timmel, Tobias Bollmann, Andreas |
Keywords: | Anticoagulants (Medicina) Fibril·lació auricular Anticoagulants Atrial Fibrillation |
Issue Date: | 11-Apr-2023 |
Publisher: | Oxford University Press (OUP) |
Abstract: | Aims To allow timely initiation of anticoagulation therapy for the prevention of stroke, the European guidelines on atrial fibrillation (AF) recommend remote monitoring (RM) of device-detected atrial high-rate episodes (AHREs) and progression of arrhythmia duration along pre-specified strata (6 min...<1h, 1 h...<24 h, >= 24h). We used the MATRIX registry data to assess the capability of a single-lead implantable cardioverter-defibrillator (ICD) with atrial sensing dipole (DX ICD system) to follow this recommendation in patients with standard indication for single-chamber ICD. Methods and results In 1841 DX ICD patients with daily automatic RM transmissions, electrograms of first device-detected AHREs per patient in each duration stratum were adjudicated, and the corresponding positive predictive values (PPVs) for the detections to be true atrial arrhythmia were calculated. Moreover, the incidence and progression of new-onset AF was assessed in 1451 patients with no AF history. A total of 610 AHREs >= 6min were adjudicated. The PPV was 95.1% (271 of 285) for episodes 6min...<1h, 99.6% (253/254) for episodes 1 h...<24h, 100% (71/71) for episodes >= 24h, or 97.5% for all episodes (595/610). The incidence of new-onset AF was 8.2% (119/1451), and in 31.1% of them (37/119), new-onset AF progressed to a higher duration stratum. Nearly 80% of new-onset AF patients had high CHA(2)DS(2)-VASc stroke risk, and 70% were not on anticoagulation therapy. Age was the only significant predictor of new-onset AF. Conclusion A 99.7% detection accuracy for AHRE >= 1h in patients with DX ICD systems in combination with daily RM allows a reliable guideline-recommended screening for subclinical AF and monitoring of AF-duration progression. [Graphics] . |
Note: | Reproducció del document publicat a: https://doi.org/10.1093/europace/euad061 |
It is part of: | Europace, 2023, vol. 25, num. 5 |
URI: | http://hdl.handle.net/2445/205794 |
Related resource: | https://doi.org/10.1093/europace/euad061 |
ISSN: | 1532-2092 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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