Arrhythmias & electrophysiology
Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care: Post Hoc Analysis of the LOOP Randomized Clinical Trial
Primary result · Bradyarrhythmia diagnosedResult — go to the resultHazard ratio 6.21 95% CI 5.15–7.48Authors' conclusion
In this study, ILR screening led to a 6-fold increase in bradyarrhythmia diagnoses and a significant increase in pacemaker implantations compared with usual care but no change in the risk of syncope or sudden death.
Study context
- Population
- Persons aged ≥70 years without known atrial fibrillation (AF) with ≥1 of hypertension, DM, HF or prior stroke, 4 sites in Denmark
- Participants
- 6,004 persons
- Comparison
- Implantable loop recorder (ILR) screening for AF vs usual care
- ILRn = 1,501
- Controln = 4,503reference
- Primary endpoint
- Adjudicated bradyarrhythmia episodes, pacemaker implantation, syncope and sudden CV death
- Follow-up
- Median 65 (IQR 59-70) months
Methodological detailspost hoc analysis, multicentre
- Post hoc analysis
- Multicentre
Primary result
Bradyarrhythmia diagnosed
Hazard ratio
6.21
95% CI 5.15–7.48
P < 0.001
Events by treatment group
ILRvs Control
HR 6.21 (95% CI 5.15–7.48); P < 0.001
As reported in the abstract
Further findings
| Outcome | ILR | Control | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Pacemaker implantation | 4.5% | 2.9% | 1.53 (1.14–2.06) | P < 0.001 | |
| Syncope | 2.2% | 2.7% | 0.83 (0.56–1.22) | P = 0.34 | |
| Sudden CV death | 1.2% | 1.1% | 1.11 (0.64–1.90) | P = 0.71 | |
| 0.512Hazard ratio (log scale) |
Risk factors and prognosis of bradyarrhythmia
- Risk factors: higher age, male sex, prior syncope
- Bradyarrhythmias associated with subsequent syncope, CV death and all-cause death; no interaction with randomisation group
Original publication
Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care: Post Hoc Analysis of the LOOP Randomized Clinical Trial. JAMA Cardiol. Published 1 April 2023. doi:10.
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