Arrhythmias & electrophysiologySecondary analysis
Cognitive function and telemedicine-based, village doctor-led care for atrial fibrillation
- post hoc subgroup analysis of the MIRACLE-AF cluster-randomized trial
- 30 village clinics in China
- December 2020 to May 2024
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
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
Summarised from the published abstract; every number is checked against it