Heart failure & cardiomyopathies
Exploration of Arrhythmia Burden in Cardiac Amyloidosis Using Implantable Loop Recorders: The EXCALIBUR Study
Authors' conclusion
In CA, clinically significant arrhythmias are common and frequently asymptomatic. Arrhythmic burden and patterns differ between amyloid subtypes and are closely associated with disease phenotype and myocardial amyloid burden.
Study context
- Population
- Treatment-naïve patients with new diagnosis of ATTR-CM or AL-CA, monitored with implantable loop recorders
- Participants
- 110 patients
- Exposure
- ATTR-CM vs AL-CA
- ATTRwt-CMn = 43
- ATTRv-CMn = 20
- AL-CAn = 47reference
- Outcome
- Bradyarrhythmias with Class I pacemaker indication
Methodological detailssingle-centre, observational
- Single-centre
- Observational
Main finding
As reported in the abstract
P = 0.036
- Overall bradyarrhythmias with Class I pacemaker indication
- 17.3%
- QRS duration and bradyarrhythmic events (sHR)
- 1.03 (95% CI 1.01-1.04; P < 0.001)
- ECV and bradyarrhythmic events (sHR)
- 1.06 (95% CI 1.02-1.10; P = 0.002)
Observational data: associations, not effects.
Further findings
| Outcome | AL-CA | P value |
|---|---|---|
| New AF (no prior AF)ATTR-CM vs AL-CA | 12.2% | P < 0.001 |
| Death during follow-up | 23.4% |
- New AF (no prior AF) — Overall new AF
- 28.2%
- New AF (no prior AF) — ECV and new AF (sHR)
- 1.04 (95% CI 1.00-1.08; P = 0.038)
- Death during follow-up — Overall deaths
- 21 (19.1%)
- Death during follow-up — Terminal rhythm in AL-CA: PEA
- 9 (81.8%)
- Death during follow-up — Terminal rhythm in AL-CA: sustained ventricular arrhythmias
- 2 (18.2%)
- New AF (no prior AF): ATTR-CM 50.0%
- Death during follow-up: ATTR-CM 15.9%
Death during follow-up
- Terminal rhythm in ATTR-CM: uniformly pulseless electrical activity
Original publication
Exploration of Arrhythmia Burden in Cardiac Amyloidosis Using Implantable Loop Recorders: The EXCALIBUR Study. J Am Coll Cardiol. Published 10 May 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →