Ability to remotely monitor atrial high-rate episodes using a single-chamber implantable cardioverter-defibrillator with a floating atrial sensing dipole

Hindricks G, Theuns DA, Bar-Lev D, Anguera I, Ayala Paredes FA, Arnold M, Geller JC, Merkely B, Dyrda KM, Perings C, Maglia G, Ploux S, Meyhöfer J, Blomström-Lundqvist C, Karjalainen P, Liang Y, Diemberger I, Wranicz JK, Barr C, Quartieri F, Timmel T, Bollmann A (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Book Volume: 25

Journal Issue: 5

DOI: 10.1093/europace/euad061

Abstract

AIMS: To allow timely initiation of anticoagulation therapy for the prevention of stroke, the European guidelines on atrial fibrillation (AF) recommend remote monitoring (RM) of device-detected atrial high-rate episodes (AHREs) and progression of arrhythmia duration along pre-specified strata (6 min…<1 h, 1 h…<24 h, ≥ 24 h). We used the MATRIX registry data to assess the capability of a single-lead implantable cardioverter-defibrillator (ICD) with atrial sensing dipole (DX ICD system) to follow this recommendation in patients with standard indication for single-chamber ICD. METHODS AND RESULTS: In 1841 DX ICD patients with daily automatic RM transmissions, electrograms of first device-detected AHREs per patient in each duration stratum were adjudicated, and the corresponding positive predictive values (PPVs) for the detections to be true atrial arrhythmia were calculated. Moreover, the incidence and progression of new-onset AF was assessed in 1451 patients with no AF history. A total of 610 AHREs ≥6 min were adjudicated. The PPV was 95.1% (271 of 285) for episodes 6min…<1 h, 99.6% (253/254) for episodes 1 h…<24 h, 100% (71/71) for episodes ≥24 h, or 97.5% for all episodes (595/610). The incidence of new-onset AF was 8.2% (119/1451), and in 31.1% of them (37/119), new-onset AF progressed to a higher duration stratum. Nearly 80% of new-onset AF patients had high CHA2DS2-VASc stroke risk, and 70% were not on anticoagulation therapy. Age was the only significant predictor of new-onset AF. CONCLUSION: A 99.7% detection accuracy for AHRE ≥1 h in patients with DX ICD systems in combination with daily RM allows a reliable guideline-recommended screening for subclinical AF and monitoring of AF-duration progression.

Authors with CRIS profile

Involved external institutions

Semmelweis University / Semmelweis Egyetem Hungary (HU) Institut de Cardiologie de Montréal Canada (CA) Azienda Ospedaliera Pugliese Ciaccio Italy (IT) Hôpital Haut-Levêque - CHU de Bordeaux France (FR) Satakunta Central Hospital Finland (FI) PLA Northern Theater Command General Hospital / 中国人民解放军沈阳军区总医院 China (CN) University of Bologna / Università di Bologna Italy (IT) Herzzentrum Leipzig Germany (DE) Erasmus University Medical Center (MC) Netherlands (NL) Chaim Sheba Medical Center at Tel HaShomer / המרכז הרפואי עש חיים שיבא – תל השומר‎‎ Israel (IL) Bellvitge University Hospital / Hospital Universitari de Bellvitge Spain (ES) Université de Sherbrooke Canada (CA) Zentralklinikum Bad Berka Germany (DE) Medical University of Łódź / Uniwersytet Medyczny w Łodzi Poland (PL) Russells Hall Hospital United Kingdom (GB) BIOTRONIK SE & Co. KG Germany (DE)

How to cite

APA:

Hindricks, G., Theuns, D.A., Bar-Lev, D., Anguera, I., Ayala Paredes, F.A., Arnold, M.,... Bollmann, A. (2023). Ability to remotely monitor atrial high-rate episodes using a single-chamber implantable cardioverter-defibrillator with a floating atrial sensing dipole. Europace, 25(5). https://doi.org/10.1093/europace/euad061

MLA:

Hindricks, Gerhard, et al. "Ability to remotely monitor atrial high-rate episodes using a single-chamber implantable cardioverter-defibrillator with a floating atrial sensing dipole." Europace 25.5 (2023).

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