Continuous monitoring of common arrhythmia leads to early intervention and improved rhythm control

NEW ORLEANS, LA, May 20, 2023 – Findings from a new clinical trial support use of implantable cardiac monitors (ICM) as a standard of care in managing patients with complex cardiac arrhythmias like atrial fibrillation (AF). The study will be presented today as a late-breaking clinical trial at Heart Rhythm 2023.

AF is a common heart rhythm disorder that can lead to blood clots, stroke, heart failure and other heart-related complications¹. Because AF symptoms and episodes can vary among patients, monitoring can inform AF management and overall patient care. While conventional monitoring happens intermittently, ICMs allow physicians to continuously monitor AF burden in a dynamic way outside of a clinical setting. The MONITOR AF study included a multi-institutional prospective registry that sought to assess how dynamic monitoring of arrhythmias, like AF, can help inform patient care decisions and improve access to care.

The study enrolled patients with and without ICMs and measured the difference in various aspects of AF management including access to care, time to initiation and change of antiarrhythmic drugs, and time to ablation. A total of 2458 AF patients were enrolled in the study (ICM group – 1152, Non-ICM group-1306). Patients with pacemakers and implantable defibrillators, ICMs for cryptogenic stroke, and those who had AF ablation prior to enrollment were excluded. The mean age was 73±12 vs 74±10, p=0.78 (Males 65±5 vs 62±6, p=0.56; Paroxysmal AF 68±5 vs 65±6, p=0.34).
During a mean follow up of 24 months – the median time to antiarrhythmic drug therapy (AAD) start (36 vs 46 days), time to first ablation (5 vs 14 months), no. of external monitors used (0 vs 4) and time to redo ablation (73 vs 165 days) were significantly better in the ICM than the Non-ICM group.

"AF is a chronic disease that requires long-term monitoring, yet the tools used today to measure the success of interventions are limited. Our goal was to better understand how ICMs can help provide improved symptom control and overall clinical decision making," said Dhanunjaya Lakkireddy, MD, Kansas City Heart Rhythm Institute at HCA Midwest Health. "Like we’ve seen with diabetes management, care guided by real-time data aided by improved technology rather than point-in-time assessments allows more precise, individualized AF patient management. We believe results show how dynamic monitoring can improve access to care, early intervention and ongoing decision making to result in better patient outcomes."

Dynamic monitoring of AF allows for significantly improved care pathways leading to early intervention, improved rhythm control and significant reduction in AF related morbidity and mortality. The authors of this study hope to see ICMs considered as a longer-term management option for AF.

¹ Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the management of atrial fibrillation: the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010;31(19):2369-2429. doi:10.1093/eurheartj/ehq278

Session Details

"Late Breaking Clinical Trials and Science – AF: Updates and Registries: Dynamic Data Driven Management of Atrial Fibrillation Using Implantable Cardiac Monitors – The MONITOR AF Study" [Saturday, May 20, 2023 at 9:30 am CT]

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About the Heart Rhythm Society

The Heart Rhythm Society (HRS) is a 501(c)(3) international nonprofit organization and the preeminent leader in science, education, and advocacy for cardiac arrhythmia professionals and patients. HRS continues to be the primary information resource on heart rhythm disorders with a mission to improve the care of patients by promoting research, education, and optimal health care policies and standards, and a mission to eliminate death and suffering due to heart rhythm disorders. Incorporated in 1979 and based in Washington, D.C., it has a membership of more than 8,000 heart rhythm professionals from 94 countries. For more information, visit www.HRSonline.org.

About Heart Rhythm 2023

The Heart Rhythm Society's annual Heart Rhythm meeting convenes 7,000+ of the world’s finest clinicians, scientists, researchers, and innovators in the field of cardiac pacing and electrophysiology. More than 1,500 international experts in the field will serve as faculty and presenters for the 200+ educational sessions, forums, symposia, and ceremonies, while 120+ exhibitors will showcase innovative products and services. For more information, visit www.HeartRhythm.com.