Detection of atrial fibrillation by implanted devices with wireless data transmission capability.
Remote telemetry may facilitate the management of implantable devices. We tested the reliability of a new automatic, wireless home monitoring (HM) system that archives data every 24 hours. We retrospectively analyzed archival data from 276 consecutive pacing system implants to define temporal atrial fibrillation (AF) patterns and associated ventricular rate. An "AF day" was defined by a >20%/24 hour mode switch (MS) duration, irrespective of the MS number. Management decisions resulting from transmissions were noted. A pilot study confirmed that 89% of 22,356 transmissions were successful, of which >90% were received in <5 minutes. Data integrity was 100% preserved. Overall, AF developed in 29 patients (10.5%), representing a total of 645 AF days (mean = 22.2 +/- 29.6 AF, median = 9 days), over 12 +/- 2 months of monitoring. AF was infrequent (<AF 30 days/year) in 80% of patients. When AF did occur, 83% patients had >/=1 day during which the AF burden was >50% of 24 hours. Ventricular rates during 645 AF days in 29 patients averaged 95.1 +/- 9.9 beats/min (median = 94 beats/min). Ventricular rates were >80 beats/min in 25 +/- 30 AF days (median = 11 days). HM enabled rapid anticoagulation decisions. In recipients of implantable devices, automatic wireless telemetry with HM was efficient and reliable. Its application may overcome some current challenges in AF management by early notification and precise measurement of both AF burden and ventricular rate during AF.
Varma
Niraj
N
Cardiac Electrophysiology, University Hospitals/Case Western Reserve University, Cleveland, Ohio, USA. niraj.varma@case.edu
Stambler
Bruce
B
Chun
Sung
S
D001281:Atrial Fibrillation / Q000175:diagnosis*; D006801:Humans; D020407:Internet; D018670:Monitoring, Ambulatory / Q000379:methods*; D010865:Pilot Projects; D019736:Prostheses and Implants; D017216:Telemedicine; D013997:Time Factors