Electrophysiologists Mark H. Schoenfeld, MD, at the Yale School of Medicine, and Kristen K. Patton, MD, University of Washington, co-authored an editorial published in JAMA Cardiology on heart rhythm monitoring technology to detect undiagnosed arrhythmias.
Advanced screening using ILR techniques may identify high-risk patients and also raises further questions as to whether bradyarrhythmias may be a risk marker for underlying nonarrhythmic conditions.
Mark H. Schoenfeld, MD
The LOOP trial enrolled 6,004 individuals with a high-risk for stroke without known arrhythmias or a rapid heart rhythm, over the age of 70. Eligible participants were randomized to receive screening to prevent stroke using an implantable loop recorder (ILR) or standard care. ILR screening improved the chance of making a diagnosis of atrial fibrillation, but also incidentally identified a surprisingly high prevalence of bradycardia, an abnormal cardiac condition where the heart rate is less than 60 beats per minute, than individuals who were randomized to the usual-care control group. Bradyarrhythmias detected in this population was associated with a markedly increased loss of consciousness (syncope), cardiovascular death, and death due to all causes, independent of treatment.
“This new data suggests that there is a high-rate of bradyarrhythmias that are detectable. Advanced screening using ILR techniques may identify high-risk patients and also raises further questions as to whether bradyarrhythmias may be a risk marker for underlying nonarrhythmic conditions,” said Schoenfeld, who co-wrote the 2018 guidelines for the management of bradycardia.
Listen to the full interview with Schoenfeld and Søren Zöga Diederichsen, MD, PhD, on the JAMA Network podcast episode, “Prevalence and Prognostic Significance of Bradyarrhythmias in Patients Screened for Atrial Fibrillation vs Usual Care.”
Heart Rhythm Society 2023 in New Orleans
Schoenfeld will present “EP Workforce: Models and Trends” on Friday, May 19, and “Clinical Practice EP Perspective - Let's Not Rock The Boat,” on Saturday, May 20, at the 2023 Heart Rhythm Society Annual Scientific Sessions in New Orleans, LA. Visit the online planner to learn more.