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
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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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cited_by cdi_FETCH-LOGICAL-c6055-968669f0d161ff43e65610127134b6e5799b43d3244c868540f04ed11fc0b4413
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container_end_page 220
container_issue 2
container_start_page 213
container_title Journal of arrhythmia
container_volume 38
creator 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
description 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 
doi_str_mv 10.1002/joa3.12685
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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 &lt; .0001). Therapy adjustment in actionable AHREs occurred 77 days earlier in the RM‐ON group versus the control group (p &lt; .001). In the RM‐ON group, there were 50% less in‐office visits as compared to the RM‐OFF group (p &lt; .001). Conclusions In our pacemaker population with no history of atrial fibrillation, RM allowed significant reduction of AHRE evaluation delay and prompted treatment of actionable episodes as compared to biannual in‐office visit schedule. Remote monitoring of pacemakers allowed significant reduction of atrial high rate episode evaluation delay and prompted treatment of actionable episodes as compared to standard care. In patients followed with the remote monitoring technology a 50% reduction in office visits was observed as compared to conventional follow‐up.</description><identifier>ISSN: 1880-4276</identifier><identifier>EISSN: 1883-2148</identifier><identifier>DOI: 10.1002/joa3.12685</identifier><identifier>PMID: 35387134</identifier><language>eng</language><publisher>Japan: John Wiley &amp; Sons, Inc</publisher><subject>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</subject><ispartof>Journal of arrhythmia, 2022-04, Vol.38 (2), p.213-220</ispartof><rights>2022 The Authors. published by John Wiley &amp; Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society.</rights><rights>2022 The Authors. Journal of Arrhythmia published by John Wiley &amp; Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society.</rights><rights>COPYRIGHT 2022 John Wiley &amp; Sons, Inc.</rights><rights>2022. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6055-968669f0d161ff43e65610127134b6e5799b43d3244c868540f04ed11fc0b4413</citedby><cites>FETCH-LOGICAL-c6055-968669f0d161ff43e65610127134b6e5799b43d3244c868540f04ed11fc0b4413</cites><orcidid>0000-0002-9227-0360</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2646639313/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2646639313?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,11541,25731,27901,27902,36989,36990,44566,46027,46451,53766,53768,74869</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35387134$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Russo, Vincenzo</creatorcontrib><creatorcontrib>Rapacciuolo, Antonio</creatorcontrib><creatorcontrib>Rago, Anna</creatorcontrib><creatorcontrib>Tavoletta, Vincenzo</creatorcontrib><creatorcontrib>De Vivo, Stefano</creatorcontrib><creatorcontrib>Ammirati, Giuseppe</creatorcontrib><creatorcontrib>Pergola, Valerio</creatorcontrib><creatorcontrib>Ciriello, Giovanni Domenico</creatorcontrib><creatorcontrib>Napoli, Paola</creatorcontrib><creatorcontrib>Nigro, Gerardo</creatorcontrib><creatorcontrib>D'Onofrio, Antonio</creatorcontrib><title>Early evaluation of atrial high rate episodes using remote monitoring in pacemaker patients: Results from the RAPID study</title><title>Journal of arrhythmia</title><addtitle>J Arrhythm</addtitle><description>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 &lt; .0001). Therapy adjustment in actionable AHREs occurred 77 days earlier in the RM‐ON group versus the control group (p &lt; .001). In the RM‐ON group, there were 50% less in‐office visits as compared to the RM‐OFF group (p &lt; .001). Conclusions In our pacemaker population with no history of atrial fibrillation, RM allowed significant reduction of AHRE evaluation delay and prompted treatment of actionable episodes as compared to biannual in‐office visit schedule. Remote monitoring of pacemakers allowed significant reduction of atrial high rate episode evaluation delay and prompted treatment of actionable episodes as compared to standard care. In patients followed with the remote monitoring technology a 50% reduction in office visits was observed as compared to conventional follow‐up.</description><subject>Atrial fibrillation</subject><subject>atrial high rate episodes</subject><subject>atrial tachyarrhythmias</subject><subject>Cardiac arrhythmia</subject><subject>Cardiomyopathy</subject><subject>Comparative analysis</subject><subject>Diabetes</subject><subject>Heart failure</subject><subject>Hypertension</subject><subject>Hypotheses</subject><subject>Kidney diseases</subject><subject>Medical equipment</subject><subject>Original</subject><subject>pacemaker</subject><subject>Pacemakers</subject><subject>Patients</subject><subject>Physiological apparatus</subject><subject>remote monitoring</subject><subject>Sinuses</subject><subject>Statistical analysis</subject><subject>Stroke</subject><subject>Telemedicine</subject><issn>1880-4276</issn><issn>1883-2148</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp9klFv0zAQgCMEYmPwwg9AlnhBSC2-2HEcHpCqMaBo0tAEz5bjnFuXJO7sZKj_HqcdgyKE_GDr_Pk73-my7DnQOVCav9l4zeaQC1k8yE5BSjbLgcuH-zOd8bwUJ9mTGDeUFpIDPM5OWMFkCYyfZrsLHdodwVvdjnpwvifeEj0Ep1uydqs1CXpAglsXfYORjNH1KxKw8yna-d4NPkwR15OtNtjp7xjSaXDYD_EtucY4tkMkNviODGsk14svy_ckDmOze5o9srqN-OxuP8u-fbj4ev5pdnn1cXm-uJwZQYtiVgkpRGVpAwKs5QxFIYBCPn2_FliUVVVz1rCccyNTCzi1lGMDYA2tOQd2li0P3sbrjdoG1-mwU147tQ_4sFI6DM60qHhT1RaMgbqoOBiQleBaFiWtkBrMdXK9O7i2Y91hY1KVQbdH0uOb3q3Vyt8qWZVl8iTBqztB8DcjxkF1LhpsW92jH6PKBZdUMC7LhL78C934MfSpVRMlBKsYsN_USqcCXG99ymsmqVqUvKK0hGJyzf9BpdVg54zv0boUP3rw-vDABB9jQHtfI1A1DZ2ahk7thy7BL_7syj36a8oSAAfgR0qz-49Kfb5asIP0J82S32g</recordid><startdate>202204</startdate><enddate>202204</enddate><creator>Russo, Vincenzo</creator><creator>Rapacciuolo, Antonio</creator><creator>Rago, Anna</creator><creator>Tavoletta, Vincenzo</creator><creator>De Vivo, Stefano</creator><creator>Ammirati, Giuseppe</creator><creator>Pergola, Valerio</creator><creator>Ciriello, Giovanni Domenico</creator><creator>Napoli, Paola</creator><creator>Nigro, Gerardo</creator><creator>D'Onofrio, Antonio</creator><general>John Wiley &amp; Sons, Inc</general><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-9227-0360</orcidid></search><sort><creationdate>202204</creationdate><title>Early evaluation of atrial high rate episodes using remote monitoring in pacemaker patients: Results from the RAPID study</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6055-968669f0d161ff43e65610127134b6e5799b43d3244c868540f04ed11fc0b4413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Atrial fibrillation</topic><topic>atrial high rate episodes</topic><topic>atrial tachyarrhythmias</topic><topic>Cardiac arrhythmia</topic><topic>Cardiomyopathy</topic><topic>Comparative analysis</topic><topic>Diabetes</topic><topic>Heart failure</topic><topic>Hypertension</topic><topic>Hypotheses</topic><topic>Kidney diseases</topic><topic>Medical equipment</topic><topic>Original</topic><topic>pacemaker</topic><topic>Pacemakers</topic><topic>Patients</topic><topic>Physiological apparatus</topic><topic>remote monitoring</topic><topic>Sinuses</topic><topic>Statistical analysis</topic><topic>Stroke</topic><topic>Telemedicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Russo, Vincenzo</creatorcontrib><creatorcontrib>Rapacciuolo, Antonio</creatorcontrib><creatorcontrib>Rago, Anna</creatorcontrib><creatorcontrib>Tavoletta, Vincenzo</creatorcontrib><creatorcontrib>De Vivo, Stefano</creatorcontrib><creatorcontrib>Ammirati, Giuseppe</creatorcontrib><creatorcontrib>Pergola, Valerio</creatorcontrib><creatorcontrib>Ciriello, Giovanni Domenico</creatorcontrib><creatorcontrib>Napoli, Paola</creatorcontrib><creatorcontrib>Nigro, Gerardo</creatorcontrib><creatorcontrib>D'Onofrio, Antonio</creatorcontrib><collection>Wiley-Blackwell Open Access Collection</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; 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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 &lt; .0001). Therapy adjustment in actionable AHREs occurred 77 days earlier in the RM‐ON group versus the control group (p &lt; .001). In the RM‐ON group, there were 50% less in‐office visits as compared to the RM‐OFF group (p &lt; .001). Conclusions In our pacemaker population with no history of atrial fibrillation, RM allowed significant reduction of AHRE evaluation delay and prompted treatment of actionable episodes as compared to biannual in‐office visit schedule. Remote monitoring of pacemakers allowed significant reduction of atrial high rate episode evaluation delay and prompted treatment of actionable episodes as compared to standard care. In patients followed with the remote monitoring technology a 50% reduction in office visits was observed as compared to conventional follow‐up.</abstract><cop>Japan</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>35387134</pmid><doi>10.1002/joa3.12685</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-9227-0360</orcidid><oa>free_for_read</oa></addata></record>
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source Wiley-Blackwell Open Access Collection; Publicly Available Content Database (Proquest) (PQ_SDU_P3); PubMed Central
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
title Early evaluation of atrial high rate episodes using remote monitoring in pacemaker patients: Results from the RAPID study
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