AF and remote monitoring

Patient

53-year-old man implanted with a triple-chamber defibrillator Consulta CRT-D for idiopathic cardiomyopathy with left bundle branch block; remote monitoring follow-up.

Trace

remote transmission of an episode of AF with alternating paced and spontaneous QRS;=
the Cardiac Compass report received identifies:
a long standing episode of AF, lasting several days, one episode of arrhythmia lasting the entire day;
an increase in the ventricular heart rate;
a significant drop in the percentage of biventricular pacing with a clear cut-off at the onset of the AF episode;
a relatively high ventricular rate, particularly during the day;
a decrease in patient activity.

Comments

This tracing highlights the various advantages of a remote monitoring in a CRT patient with episodes of atrial arrhythmia:

the diagnosis is confirmed by the analysis of the transmitted EGM; this allows eliminating false diagnoses of atrial arrhythmia (crosstalk, noise, etc.),
the diagnosis is quickly performed even if the patient is asymptomatic,
anticoagulant therapy could be introduced early to reduce the risk of stroke,
the treatment with an anti-arrhythmic was also introduced; the effectiveness of this treatment can be remotely assessed on a daily basis through the remote monitoring follow-up.

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AF and remote monitoring

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