Arrhythmias & electrophysiology

Cognitive function and telemedicine-based, village doctor-led care for atrial fibrillation

EuropacePublished post hoc subgroup analysis of the MIRACLE-AF cluster-randomized trial

Authors' conclusion

A telemedicine-based, village doctor-led integrated care model was associated with favourable outcomes across baseline cognitive strata, warranting further evaluation among cognitively vulnerable adults with AF in rural settings.

Study context

Population
Rural participants aged ≥65 years with atrial fibrillation (AF)enrolled in the MIRACLE-AF trial, 1028 (98.9%) had baseline Mini-Mental State Examination (MMSE) assessed · MMSE < 18 388 · MMSE 18-23 305 · MMSE ≥ 24 335
Participants
1,039 participants
Comparison
Telemedicine-based, village doctor-led integrated AF care or usual care, by baseline MMSE category
Primary endpoint
composite of:
  • Cardiovascular death
  • All strokes
  • Hospitalization for worsening heart failure or acute coronary syndrome
  • Emergency visits for AF
Methodological details30 village clinics in China, December 2020 to May 2024
  • 30 village clinics in China
  • December 2020 to May 2024

Primary result

As reported in the abstract

intervention vs controlAdjusted hazard ratio (95% CI)
MMSE 18-23
0.56(0.34–0.92)
MMSE ≥ 24
0.55(0.32–0.93)
MMSE < 18
0.86(0.54–1.35)

Further findings

Baseline characteristics

Mean (SD) age
75.8 (5.7) years
Women
460 (44.3%)

Original publication

Cognitive function and telemedicine-based, village doctor-led care for atrial fibrillation. Europace. Published 28 August 2026. doi:10.1093/europace/euag233

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