title: Early Detection and Treatment of Atrial Arrhythmias Alleviates the Arrhythmic Burden in Paced Patients: The SETAM Study.
abstract: BACKGROUND
  Remote monitoring (RM) can remotely detect atrial tachyarrhythmias (ATAs). The benefit of RM compared to conventional follow-up in the detection and management of ATA was assessed in recipients of dual-chamber pacemakers.
  
  
  METHODS
  The multicenter randomized SETAM study enrolled 595 patients in sinus rhythm with a CHA2DS2-VASc score ≥2, without ATA history and untreated with antiarrhythmics and antithrombotics, randomly assigned to RM (RM-ON; n = 291) versus ambulatory follow-up (RM-OFF; n = 304) during 12.8 ± 3.3 months. ATA occurrence, burden, and management were analyzed together with adverse clinical events.
  
  
  RESULTS
  Patients were 79 ± 8 years old, 63% men, with a CHA2DS2-VASc score of 3.7± 1.2. ATA were detected in 83 patients (28%) in the RM-ON versus 66 (22%) in the RM-OFF group (P = 0.06). The median time between the pacemaker implantation and the first treated ATA was 114 days [44; 241] in the RM-ON versus 224 days [67; 366] in the RM-OFF group (hazard ratio [HR] = 0.56; 95% confidence interval [CI]: 0.37-0.86; P = 0.01). Therapies for ATA were initiated in 92 patients and the time to treatment of ATA was shortened by 44% in the RM-ON group (HR = 0.565; 95% CI: 0.37-0.86; P = 0.01). Over the last 4 months of follow-up, the mean ATA burden was alleviated by 4 hours/day (18%) in the RM-ON group. The rate of adverse clinical events was similar in both groups.
  
  
  CONCLUSIONS
  Remotely monitored patients were diagnosed and treated earlier for ATA, and subsequently had a lower ATA burden.
authors.affiliation: Centre Hospitalier Intercommunal Le Raincy-Montfermeil, Le Raincy-Montfermeil, France.
authors.forename: Walid
authors.initials: W
authors.lastname: Amara
authors.affiliation: Centre Hospitalier Bretagne Atlantique, Vannes, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Montagnier
authors.affiliation: Centre Hospitalier Henri Duffaut, Avignon, France.
authors.forename: Saïda
authors.initials: S
authors.lastname: Cheggour
authors.affiliation: Centre Hospitalier Regional Metz-Thionville, Hôpital de Mercy, Ars-Laquenexy, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Boursier
authors.affiliation: Centre Hospitalier Departemental Les Oudairies, La Roche-sur-Yon, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Gully
authors.affiliation: Centre Hospitalier du pays Aix, Aix-en-Provence, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Barnay
authors.affiliation: Centre Hospitalier de Beziers, Beziers, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Georger
authors.affiliation: Centre Hospitalier Robert Boulin, Libourne, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Deplagne
authors.affiliation: Centre Hospitalier Belfort-Montbeliard, Montbeliard, France.
authors.forename: Stephane
authors.initials: S
authors.lastname: Fromentin
authors.affiliation: Centre de Cardiologie Dorian-Liberation, Hôpital Prive de La Loire, Saint Etienne, France.
authors.forename: Marcin
authors.initials: M
authors.lastname: Mlotek
authors.affiliation: Clinique Ambroise Paré, Neuilly sur Seine, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Lazarus
authors.affiliation: Centre Hospitalier du pays Aix, Aix-en-Provence, France.
authors.forename: Jerôme
authors.initials: J
authors.lastname: Taïeb
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000401:mortality* / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000401:mortality* / Q000706:statistics & numerical data; D017281:Cost of Illness; D042241:Early Diagnosis; D015716:Electrocardiography, Ambulatory / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006699:Home Care Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D015996:Survival Rate; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis / Q000401:mortality* / Q000517:prevention & control*; D017216:Telemedicine / Q000706:statistics & numerical data*; D061665:Time-to-Treatment / Q000706:statistics & numerical data; D016896:Treatment Outcome
keywords: atrial fibrillation; atrial tachyarrhythmia burden; remote monitoring; stroke; supraventricular tachyarrhythmia