Arrhythmias & electrophysiology
Ability to remotely monitor atrial high-rate episodes using a single-chamber implantable cardioverter-defibrillator with a floating atrial sensing dipole
Authors' 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.
Study context
- Population
- Patients with standard indication for single-chamber implantable cardioverter-defibrillator (ICD) implanted with a DX ICD system (single-lead ICD with floating atrial sensing dipole)610 atrial high-rate episodes (AHREs) ≥6 min adjudicated
- Participants
- 1,841 patients
- Exposure
- 6 min…<1 h vs 1 h…<24 h vs ≥24 h
- 6 min…<1 hn = 285
- 1 h…<24 hn = 254
- ≥24 hn = 71
- Outcome
- PPV of device-detected AHREs for true atrial arrhythmia, by duration stratum
Methodological detailsdiagnostic accuracy, MATRIX registry, daily automatic remote monitoring
- Diagnostic accuracy
- MATRIX registry
- Daily automatic remote monitoring
Main finding
As reported in the abstract
PPV of AHRE detection
| Group | Value | PPV |
|---|---|---|
| 6 min…<1 h | 95.1% | 95.1% |
| 1 h…<24 h | 99.6% | 99.6% |
| ≥24 h | 100% | 100% |
Value
6 min…<1 h95.1%
1 h…<24 h99.6%
≥24 h100%
PPV
6 min…<1 h95.1%
1 h…<24 h99.6%
≥24 h100%
- PPV, all episodes (595/610)
- 97.5%
Observational data: associations, not effects.
Further findings
Incidence of new-onset atrial fibrillation (AF) (no AF history, n = 1451)
- New-onset AF (119/1451)
- 8.2%
- Progression to a higher duration stratum (37/119)
- 31.1%
- New-onset AF patients with high CHA2DS2-VASc stroke risk
- Nearly 80%
- New-onset AF patients not on anticoagulation
- 70%
- Age the only significant predictor of new-onset AF
Original publication
Ability to remotely monitor atrial high-rate episodes using a single-chamber implantable cardioverter-defibrillator with a floating atrial sensing dipole. Europace. Published 11 April 2023. doi:10.
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