Arrhythmias & electrophysiology
Telemedicine-based integrated management of atrial fibrillation in village clinics: a cluster randomized trial
Authors' conclusion
Our trial intervention by this telemedicine-based integrated care delivery model of AF care in rural villages demonstrates better adherence and improved clinical outcomes compared to usual care.
Study context
- Population
- Village residents aged ≥65 years with atrial fibrillation (AF) in rural China (30 village clinics)
- Participants
- 1,039 residents30 village clinics
- Comparison
- Telemedicine-based, village doctor-led integrated AF care vs usual care
- Primary endpoint
- Stage 1: adherence to integrated AF care; stage 2: composite of CV death, all strokes, HF or ACS hospitalization, and AF emergency visits
- Follow-up
- 12 months (stage 1); 36 months (stage 2)
Methodological details1:1 randomisation, two stages
- 1:1 randomisation
- Two stages
Primary result
As reported in the abstract
Telemedicine-based, village doctor-led care
- Met all criteria for integrated AF care at 12 months
- 33.1%
- Composite CV event rate
- 6.2% per year
Usual care
- Met all criteria for integrated AF care at 12 months
- 8.7%
- Composite CV event rate
- 9.6% per year
Met all criteria for integrated AF care at 12 months
Telemedicine-based, village doctor-led care33.1%
Usual care8.7%
Composite CV event rate
Telemedicine-based, village doctor-led care6.2% per year
Usual care9.6% per year
Telemedicine-based, village doctor-led care vs Usual careBetween-group difference (95% CI)P value
Adherence to integrated AF care at 12 months
24.4%(18.3–30.5%)
P < 0.001Telemedicine-based, village doctor-led care vs Usual careHazard ratio (95% CI)P value
Composite CV event outcome
0.64(0.50–0.82)
P < 0.001Further findings
Met all criteria for integrated AF care · Over 34.0 months
P < 0.001
Original publication
Telemedicine-based integrated management of atrial fibrillation in village clinics: a cluster randomized trial. Nat Med. Published 21 February 2025. doi:10. 1038/ s41591-025-03511-2
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