Reduction of atrial fibrillation in remotely monitored pacemaker patients： results from a Chinese multicentre registry  

作　　者：CHEN Ke-ping DAI Yan HUA Wei YANG Jie-fu LI Kang LIANG Zhao-guang SHEN Fa-rong CHEN Si-lin SUYan-gang DING Yan-sheng ZHANG Shu 

机构地区：[1]Chinese Acad Med Sci, Fuwai Hosp, Clin EP Lab, Beijing 100037, Peoples R China [2]Chinese Acad Med Sci, Fuwai Hosp, Arrhythm Ctr, Beijing 100037, Peoples R China [3]Peking Union Med Coll, Beijing 100037, Peoples R China [4]Beijing Hosp, Dept Cardiol, Beijing 100730, Peoples R China [5]Capital Med Univ, Xuan Wu Hosp, Dept Cardiol, Beijing 100053, Peoples R China [6]Harbin Med Univ, Affiliated Hosp 1, Dept Cardiol, Harbin 150001, Heilongjiang, Peoples R China [7]Zhejiang Hosp, Dept Cardiol, Hangzhou 310013, Zhejiang, Peoples R China [8]Guangdong Gen Hosp, Dept Cardiol, Guangzhou 510100, Guangdong, Peoples R China [9]Fudan Univ, Zhongshan Hosp, Dept Cardiol, Shanghai 200032, Peoples R China [10]Peking Univ, Hosp 1, Dept Cardiol, Beijing 100034, Peoples R China

出　　处：《Chinese Medical Journal》2013年第22期4216-4221,共6页中华医学杂志（英文版）

摘　　要：Background Many recipients of implantable cardiac electronic devices have atrial fibrillation （AF） occurrences after device implantation, even if there is no previous history of AF, and some of the episodes are asymptomatic. The purpose of this study was to evaluate trends in AF burden following early AF detection in patients treated with pacemakers equipped with automatic, daily Home Monitoring function. Methods Between February 2009 and December 2010, the registry recruited 701 pacemaker patients （628 dual-chamber, 73 biventricular devices） at 97 clinical centers in China. Daily Home Monitoring data transmissions were analyzed to screen for the AF burden. In-office follow-ups were scheduled for 3 and 6 months after implantation. Upon first AF （i.e., mode-switch） detection in a patient, screening olAF burden by Home Monitoring was extended for the next 180 days. Results At least one episode of AF was observed in 22.9% of patients with dual-chamber pacemakers and in 28.8% of patients with biventricular pacemakers. The first AF detection in a patient occurred, on average, about 2 months before scheduled follow-up visits. In both pacemaker groups, mean AF burden decreased significantly （P〈0.05） over 180 days following first AF detection： from 12.0% to 2.5% in dual-chamber and from 12.2% to 0.5% in biventricular pacemaker recipients. The number of patients with an AF burden 〉10% per month was significantly reduced over 6 months of implantation in both dual chamber （38 patients in the first month vs. 21 patients in month 6, P〈0.05） and biventricular （7 patients in the first month vs. 0 patient in months 4-6, P〈0.05） pacemaker recipients. Conclusions Automatic, daily Home Monitoring of patients treated with cardiac pacemakers allows early detection of AF, and there is a gradual and significant decrease in AF burden.Background Many recipients of implantable cardiac electronic devices have atrial fibrillation （AF） occurrences after device implantation, even if there is no previous history of AF, and some of the episodes are asymptomatic. The purpose of this study was to evaluate trends in AF burden following early AF detection in patients treated with pacemakers equipped with automatic, daily Home Monitoring function. Methods Between February 2009 and December 2010, the registry recruited 701 pacemaker patients （628 dual-chamber, 73 biventricular devices） at 97 clinical centers in China. Daily Home Monitoring data transmissions were analyzed to screen for the AF burden. In-office follow-ups were scheduled for 3 and 6 months after implantation. Upon first AF （i.e., mode-switch） detection in a patient, screening olAF burden by Home Monitoring was extended for the next 180 days. Results At least one episode of AF was observed in 22.9% of patients with dual-chamber pacemakers and in 28.8% of patients with biventricular pacemakers. The first AF detection in a patient occurred, on average, about 2 months before scheduled follow-up visits. In both pacemaker groups, mean AF burden decreased significantly （P〈0.05） over 180 days following first AF detection： from 12.0% to 2.5% in dual-chamber and from 12.2% to 0.5% in biventricular pacemaker recipients. The number of patients with an AF burden 〉10% per month was significantly reduced over 6 months of implantation in both dual chamber （38 patients in the first month vs. 21 patients in month 6, P〈0.05） and biventricular （7 patients in the first month vs. 0 patient in months 4-6, P〈0.05） pacemaker recipients. Conclusions Automatic, daily Home Monitoring of patients treated with cardiac pacemakers allows early detection of AF, and there is a gradual and significant decrease in AF burden.

关 键 词：home monitoring atrialfibrillation burden PACEMAKER cardiac resynchronization device 

分 类 号：TP277[自动化与计算机技术—检测技术与自动化装置] TH772.2[自动化与计算机技术—控制科学与工程]