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The LOOP trial showed that implantable loop recorders (ILRs) documented more atrial fibrillation, leading to a higher rate of anticoagulation initiation but no difference in stroke prevention (NEJM JW Cardiol Sep 9 2021 and Lancet 2021; 398:1507). In this secondary analysis, investigators analyzed the occurrence and treatment of incidentally diagnosed bradyarrhythmia (pauses ≥3 seconds or heart rate ≤30 bpm) and its effect on outcomes.
The trial included 6004 patients aged ≥70 years with a risk factor for stroke, among whom 1501 were randomized to ILR and 4503 to usual care. Bradycardias were far more likely to be diagnosed in the ILR group (21%) compared with the usual-care group (4%). However, 80% of the bradycardias were asymptomatic in t…