DENVER, May 13, 2010 – According to a new study released today at Heart Rhythm 2010, the Heart Rhythm Society’s 31st Annual Scientific Sessions, remote monitoring proves effective for earlier detection of arrhythmic events and pacemaker dysfunction in elderly patients with atrial fibrillation (AF). The study is the first to consider using remote monitoring on elderly patients to detect and treat AF compared to standard follow-up procedures.
The randomized, prospective study conducted at the Heart Institute (InCor), University of Sao Paulo Medical School in Sao Paulo, Brazil, evaluated 267 patients age 60 years and older with atrioventricular pacemaker implantation. Between March 2007 and September 2009, all patients were randomly assigned to a remote group (RG = 135) and a control group (CG = 132). Follow-up with patients was conducted in months, 1, 3, 6, 12, 18 and 24 during which variables such as age, gender, follow-up time, time to AF diagnostic, AF burden and health complications (i.e. AF incidence, stroke) were analyzed.
Time to first AF detection was nearly twice as fast in patients in the RG (48 days in RG vs. 85 days in CG, P=0.047). The majority of AF episodes detected by remote monitoring (96 percent) were asymptomatic or silent AF; however, in 86.5 percent of the patient population, remote monitoring indicated the need for therapy change. As a result, nearly nine out of ten elderly patients diagnosed with AF required alternate treatment, or pacemaker reprogramming: antithrombotic therapy in 52 percent, antiarrhythmic therapy in 22 percent, pacemaker re-programming in 4 percent and cardioversion in 4 percent. “We believe that utilizing remote monitoring for managing AF is not only safe, but more effective in comparison with standard follow-up treatments,” stated lead author Carlos E. Lima, MD, Heart Institute (InCor), University of Sao Paulo Medical School in Sao Paulo, Brazil. “By reducing the recurrence of AF, thromboembolic events and symptoms related to AF, remote monitoring can improve the patient’s overall quality of life and help determine the best possible treatment.”
Results of the study showed a high incidence of AF among the patient population, 18.7 percent with an average follow-up of 252 days. The population was composed of elderly pacemaker patients with structurally normal heart and isolated degenerative disease of the conduction system. While AF is not life-threatening on its own, it can lead to other more dangerous heart conditions, including a five times greater risk of stroke. According to this study, remote monitoring is an effective tool for earlier detection and treatment of atrial fibrillation.