Arrhythmias & electrophysiologyRandomised controlled trial
Telemedicine-based integrated management of atrial fibrillation in village clinics: a cluster randomized trial
- Cluster randomised controlled trial
- 1:1 randomisation
- two stages
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 residents · 30 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)
Primary result
As reported in the abstract
Telemedicine-based, village doctor-led care
33.1%
Met all criteria for integrated AF care at 12 months · Composite CV event rate 6.2% per year
Usual care
8.7%
Met all criteria for integrated AF care at 12 months · Composite CV event rate 9.6% 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
Summarised from the published abstract; every number is checked against it