Walid Amara1, Christian Montagnier2, Saïda Cheggour3, Michel Boursier4, Claude Gully5, Claude Barnay6, Frederic Georger7, Antoine Deplagne8, Stephane Fromentin9, Marcin Mlotek10, Arnaud Lazarus11, Jerôme Taïeb6. 1. Centre Hospitalier Intercommunal Le Raincy-Montfermeil, Le Raincy-Montfermeil, France. 2. Centre Hospitalier Bretagne Atlantique, Vannes, France. 3. Centre Hospitalier Henri Duffaut, Avignon, France. 4. Centre Hospitalier Regional Metz-Thionville, Hôpital de Mercy, Ars-Laquenexy, France. 5. Centre Hospitalier Departemental Les Oudairies, La Roche-sur-Yon, France. 6. Centre Hospitalier du pays Aix, Aix-en-Provence, France. 7. Centre Hospitalier de Beziers, Beziers, France. 8. Centre Hospitalier Robert Boulin, Libourne, France. 9. Centre Hospitalier Belfort-Montbeliard, Montbeliard, France. 10. Centre de Cardiologie Dorian-Liberation, Hôpital Prive de La Loire, Saint Etienne, France. 11. Clinique Ambroise Paré, Neuilly sur Seine, France.
Abstract
BACKGROUND:Remote monitoring (RM) can remotely detect atrial tachyarrhythmias (ATAs). The benefit of RM compared to conventional follow-up in the detection and management of ATA was assessed in recipients of dual-chamber pacemakers. METHODS: The multicenter randomized SETAM study enrolled 595 patients in sinus rhythm with a CHA2 DS2 -VASc score ≥2, without ATA history and untreated with antiarrhythmics and antithrombotics, randomly assigned toRM (RM-ON; n = 291) versus ambulatory follow-up (RM-OFF; n = 304) during 12.8 ± 3.3 months. ATA occurrence, burden, and management were analyzed together with adverse clinical events. RESULTS:Patients were 79 ± 8 years old, 63% men, with a CHA2 DS2 -VASc score of 3.7± 1.2. ATA were detected in 83 patients (28%) in the RM-ON versus 66 (22%) in the RM-OFF group (P = 0.06). The median time between the pacemaker implantation and the first treated ATA was 114 days [44; 241] in the RM-ON versus 224 days [67; 366] in the RM-OFF group (hazard ratio [HR] = 0.56; 95% confidence interval [CI]: 0.37-0.86; P = 0.01). Therapies for ATA were initiated in 92 patients and the time to treatment of ATA was shortened by 44% in the RM-ON group (HR = 0.565; 95% CI: 0.37-0.86; P = 0.01). Over the last 4 months of follow-up, the mean ATA burden was alleviated by 4 hours/day (18%) in the RM-ON group. The rate of adverse clinical events was similar in both groups. CONCLUSION: Remotely monitored patients were diagnosed and treated earlier for ATA, and subsequently had a lower ATA burden.
RCT Entities:
BACKGROUND: Remote monitoring (RM) can remotely detect atrial tachyarrhythmias (ATAs). The benefit of RM compared to conventional follow-up in the detection and management of ATA was assessed in recipients of dual-chamber pacemakers. METHODS: The multicenter randomized SETAM study enrolled 595 patients in sinus rhythm with a CHA2 DS2 -VASc score ≥2, without ATA history and untreated with antiarrhythmics and antithrombotics, randomly assigned to RM (RM-ON; n = 291) versus ambulatory follow-up (RM-OFF; n = 304) during 12.8 ± 3.3 months. ATA occurrence, burden, and management were analyzed together with adverse clinical events. RESULTS:Patients were 79 ± 8 years old, 63% men, with a CHA2 DS2 -VASc score of 3.7± 1.2. ATA were detected in 83 patients (28%) in the RM-ON versus 66 (22%) in the RM-OFF group (P = 0.06). The median time between the pacemaker implantation and the first treated ATA was 114 days [44; 241] in the RM-ON versus 224 days [67; 366] in the RM-OFF group (hazard ratio [HR] = 0.56; 95% confidence interval [CI]: 0.37-0.86; P = 0.01). Therapies for ATA were initiated in 92 patients and the time to treatment of ATA was shortened by 44% in the RM-ON group (HR = 0.565; 95% CI: 0.37-0.86; P = 0.01). Over the last 4 months of follow-up, the mean ATA burden was alleviated by 4 hours/day (18%) in the RM-ON group. The rate of adverse clinical events was similar in both groups. CONCLUSION: Remotely monitored patients were diagnosed and treated earlier for ATA, and subsequently had a lower ATA burden.
Authors: David Duncker; Roman Michalski; Johanna Müller-Leisse; Christos Zormpas; Thorben König; Christian Veltmann Journal: Herzschrittmacherther Elektrophysiol Date: 2017-08-15
Authors: Remedios López-Liria; Antonio López-Villegas; César Leal-Costa; Salvador Peiró; Emilio Robles-Musso; Rafael Bautista-Mesa; Patricia Rocamora-Pérez; Knut Tore Lappegård; Daniel Catalán-Matamoros Journal: Int J Environ Res Public Health Date: 2020-02-23 Impact factor: 3.390
Authors: Vincenzo Russo; Anna Rago; Vincenzo Tavoletta; Valter Bianchi; Cristina Carella; Giuseppe Ammirati; Aniello Viggiano; Stefano De Vivo; Antonio Rapacciuolo; Gerardo Nigro; Antonio D'Onofrio Journal: J Atr Fibrillation Date: 2018-08-31