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- Title
Early Detection and Treatment of Atrial Arrhythmias Alleviates the Arrhythmic Burden in Paced Patients: The SETAM Study.
- Authors
AMARA, WALID; MONTAGNIER, CHRISTIAN; CHEGGOUR, SAÏDA; BOURSIER, MICHEL; GULLY, CLAUDE; BARNAY, CLAUDE; GEORGER, FREDERIC; DEPLAGNE, ANTOINE; FROMENTIN, STEPHANE; MLOTEK, MARCIN; LAZARUS, ARNAUD; TAÏEB, JERÔME
- 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 CHA2DS2-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 CHA2DS2-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.
- Subjects
HEART diseases; THERAPEUTICS; ATRIAL arrhythmias; CARDIAC pacemakers; CARDIAC pacing; CONFIDENCE intervals; MEDICAL cooperation; PATIENT monitoring; PROBABILITY theory; RESEARCH; STATISTICAL sampling; REMOTE access networks; RANDOMIZED controlled trials; EARLY medical intervention; EARLY diagnosis; DESCRIPTIVE statistics; DIAGNOSIS
- Publication
Pacing & Clinical Electrophysiology, 2017, Vol 40, Issue 5, p527
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/pace.13062