Association of Atrial Fibrillation Burden and Mortality Among Patients With Cardiac Implantable Electronic Devices

• DOI: 10.1161/circulationaha.124.069757
• Publication Date: 2024-06-28T09:01:08Z
• Authors: Graham Peigh; Jiani Zhou; Sarah C. Rosemas; Anthony I. Roberts; Colleen Longacre; Katherine Trinh; Tanvi Nayak; Dana Soderlund; Rod S. Passman
• Keywords: Association (psychology)

Current estimates of atrial fibrillation (AF)-associated mortality rely on claims- or clinical-derived diagnoses AF, limit AF to a binary entity, are confounded by comorbidities. The objective the present study is assess association between device-recognized and among patients with cardiac implantable electronic devices capable sensitive continuous arrhythmia detection. Secondary outcomes include relative cohorts no paroxysmal persistent permanent AF. Using deidentified Optum Clinformatics US claims database (2015 2020) linked Medtronic CareLink database, we identified individuals device who transmitted data ≥6 months after implantation. burden was assessed during first 6 implantation (baseline period). Subsequent mortality, from data, compared without adjustment for age, geographic region, insurance type, Charlson Comorbidity Index, year. Of 21 391 (age, 72.9±10.9 years; 56.3% male) analyzed, 7798 (36.5%) had During mean 22.4±12.9 (median, 20.1 [12.8-29.7] months) follow-up, overall incidence 13.5%. Patients higher adjusted all-cause than (hazard ratio, 1.29 [95% CI, 1.20-1.39]; P<0.001). Among those nonparoxysmal greatest risk (persistent versus AF: hazard 1.36 1.18-1.58]; P<.001; 1.23 1.14-1.34]; P<.001). After potential confounding factors, presence associated in our cohort devices. mortality.