Literature DB >> 26413928

Silent Atrial Fibrillation in Elderly Pacemaker Users: A Randomized Trial Using Home Monitoring.

Ceb Lima1,2, M Martinelli1, G L Peixoto1, S F Siqueira1, Maurício Wajngarten1, Rodrigo Tavares Silva1, Roberto Costa1, Roberto Filho1, José Antônio Franchini Ramires1.   

Abstract

BACKGROUND: Pacemaker with remote monitoring (PRM) may be useful for silent atrial fibrillation (AF) detection. The aims of this study were to evaluate the incidence of silent AF, the role of PRM, and to determine predictors of silent AF occurrence.
METHODS: Three hundred elderly patients with permanent pacemaker (PPM) were randomly assigned to the remote group (RG) or control group (CG). All patients received PPM with remote monitoring capabilities. Primary end point was AF occurrence rate and the secondary end points were time to AF detection and number of days with AF.
RESULTS: During the average follow-up of 15.7±7.7 months, AF episodes were detected in 21.6% (RG = 24% vs CG = 19.3%, P = 0.36]. There was no difference in the time to detect the first AF episode. However, the median time to detect AF recurrence in the RG was lower than that in the CG (54 days vs 100 days, P = 0.004). The average number of days with AF was 16.0 and 51.2 in the RG and CG, respectively (P = 0.028). Predictors of silent AF were left atrial diameter (odds ratio [OR] 1.2; 95% CI = 1.1-1.3; P < 0.001) and diastolic dysfunction (OR 4.8; 95% CI = 1.6-14.0; P = 0.005).
CONCLUSIONS: The incidence of silent AF is high in elderly patients with pacemaker; left atrial diameter and diastolic dysfunction were predictors of its occurrence. AF monitoring by means of pacemaker is a valuable tool for silent AF detection and continuous remote monitoring allows early AF recurrence detection and reduces the number of days with AF.
© 2015 Wiley Periodicals, Inc.

Entities:  

Keywords:  atrial fibrillation; elderly; home monitoring; pacemaker

Mesh:

Year:  2015        PMID: 26413928      PMCID: PMC6931447          DOI: 10.1111/anec.12294

Source DB:  PubMed          Journal:  Ann Noninvasive Electrocardiol        ISSN: 1082-720X            Impact factor:   1.468


  31 in total

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  9 in total

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