Detectability of Cardiac Arrhythmias in Elderly and Senile Patients in Remote Telemetry and on In-Person Clinic Visits after Pacemaker Implantation

INTRODUCTION: Increase in life expectancy in the world is accompanied by growth of cardiovascular diseases, which is associated with increase in the frequency of heart rhythm and conduction disorders in elderly and senile patients. Potentials of modern pacemakers allow saving parameters of arrhythmia in the memory of the device and transmitting information to the doctor via satellite communications. AIM: Comparison of the prevalence of heart rhythm disorders in elderly and senile patients after pacemaker implantation followed-up in person in the clinic and using remote telemetry. MATERIALS AND METHODS: The study included 94 patients (50% of men) of the mean age (71.6 years). After pacemaker implantation, patients were divided into 2 groups: the experimental group that was given a Medtronic Care Link (model 24950) monitor for remote data transmission, and the control group of patients followed-up in person. The control and experimental groups were comparable in age, gender, clinical nosologies and complications (р >0.05). Intracardiac endograms were analyzed excluding cases of overdiagnosis of arrhythmia associated with hypersensing. RESULTS: A total of 396 intracardiac endograms were reviewed. In the experimental group, compared to the control group, tachyarrhythmia was recorded statistically more. In the experimental group 17 episodes of tachyarrhythmia were recorded, in the control group 12 episodes were detected. CONCLUSIONS: The prevalence of tachyarrhythmia in patients with dual-chamber pacemakers in one year of follow-up was 42.5% in the experimental group and 22.5% in the group of in-person observation. The chances for detecting arrhythmia in patients using remote telemetry were 2.59 times higher than in patients observed in-person. Early detection of atrial fibrillation in patents of the experimental group allowed timely prescription of anticoagulant therapy and reduced the risk of the development of thromboembolic complications.