Heart failure & cardiomyopathiesCohort study
Exploration of Arrhythmia Burden in Cardiac Amyloidosis Using Implantable Loop Recorders
- Prospective cohort study
- single-centre
- observational
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
Main finding
As reported in the abstract
Bradyarrhythmias with Class I pacemaker indication
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 | ATTRwt-CM | ATTRv-CM | AL-CA | P value |
|---|---|---|---|---|
| New AF (no prior AF) | Not reported in the abstract | Not reported in the abstract | 12.2% | P < 0.001 |
| Death during follow-up | Not reported in the abstract | Not reported in the abstract | 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. J Am Coll Cardiol. Published 10 May 2026. doi:10.1016/j.jacc.2026.04.030
Summarised from the published abstract; every number is checked against it