Early evaluation of atrial high rate episodes using remote monitoring in pacemaker patients: Results from the RAPID study

Aim Remote monitoring (RM) of implantable cardiac devices has enabled continuous surveillance of atrial high rate episodes (AHREs) with well‐recognized clinical benefits. We aimed to add evidence on the role of the RM as compared to conventional follow‐up by investigating the interval from AHRE onse...

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Published in:Journal of arrhythmia 2022-04, Vol.38 (2), p.213-220
Main Authors: Russo, Vincenzo, Rapacciuolo, Antonio, Rago, Anna, Tavoletta, Vincenzo, De Vivo, Stefano, Ammirati, Giuseppe, Pergola, Valerio, Ciriello, Giovanni Domenico, Napoli, Paola, Nigro, Gerardo, D'Onofrio, Antonio
Format: Article
Language:English
Subjects:
Atrial fibrillation
atrial high rate episodes
atrial tachyarrhythmias
Cardiac arrhythmia
Cardiomyopathy
Comparative analysis
Diabetes
Heart failure
Hypertension
Hypotheses
Kidney diseases
Medical equipment
Original
pacemaker
Pacemakers
Patients
Physiological apparatus
remote monitoring
Sinuses
Statistical analysis
Stroke
Telemedicine
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Summary:Aim Remote monitoring (RM) of implantable cardiac devices has enabled continuous surveillance of atrial high rate episodes (AHREs) with well‐recognized clinical benefits. We aimed to add evidence on the role of the RM as compared to conventional follow‐up by investigating the interval from AHRE onset to physician’s evaluation and reaction time in actionable episodes. Methods and Results A total of 97 dual‐chamber pacemaker recipients were followed with RM (RM‐ON group; N = 64) or conventional in‐office visits (RM‐OFF group; N = 33) for 18 months. In‐office visits were scheduled at 1, 6, 12, and 18 months in the RM‐OFF group and at 1 and 18 months in the RM‐ON group. The overall AHRE rate was 1.98 per patient‐year (95% confidence interval [CI], 1.76–2.20) with no difference between the two groups (RM‐ON vs. RM‐OFF weighted‐HR, 0.88; CI, 0.36–2.13; p = .78). In the RM‐ON group, 100% AHREs evaluated within 11 days from onset, and within 202 days in the RM‐OFF group, with a median evaluation delay 79 days shorter in the RM‐ON group versus the RM‐OFF group (p 
ISSN:1880-4276
1883-2148
DOI:10.1002/joa3.12685