April 1, 2019European Heart Journal SupplementsOpen Access

New onset of chest pain: the importance of remote monitoring

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Why the study?

The clinical management of device-detected atrial high-rate episodes is controversial, with debate surrounding rhythm versus rate control and scarce evidence regarding oral anticoagulation.

Population

One 64-year-old Caucasian man with an ICD for secondary prevention

Comparison

Rhythm control vs initial rate control strategy

Design

Case report

Follow-up

3 years

Authors

MBMatteo BertiniElectrophysiology CBCristina BallaElectrophysiology MMMichele MalagùUniversity of Ferrara

Discussion

Member takes

Implication

Supports monitoring LV function in AF patients with AHREs; extends bidirectional interaction evidence in device populations.

Structured PICO

Population

1 64-year-old Caucasian man with a history of hypertension, previous myocardial infarction (CABG 10 years prior), and a dual-chamber ICD implanted for secondary prevention of aborted sudden cardiac death, who developed subclinical atrial fibrillation and heart failure symptoms.

Intervention

Remote monitoring for early detection of atrial fibrillation, followed by a rhythm control strategy (amiodarone and electrical cardioversion) and rivaroxaban.

Comparator

Initial rate control strategy (bisoprolol 10 mg/day).

Outcome

Resolution of symptoms (chest pain, fatigue, dyspnea) and improvement in left ventricular ejection fraction.

Remote monitoring via CIEDs allows early detection of subclinical atrial fibrillation, enabling prompt initiation of rhythm control and anticoagulation to improve heart failure symptoms and LV function.

Cite This Study

Bertini et al. (2019) studied this question.

synapsesocial.com/papers/6a7a9d63756812e39589adca https://doi.org/10.1093/eurheartj/suz036

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