Continuous cardiac monitoring around Atrial fibrillation ablation: insights on clinical classifications and end points

Lukas R.C. Dekker, Evgeny Pokushalov, Prashanthan Sanders, Katherine A. Lindborg, Bärbel Maus, Helmut Pürerfellner

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)

Abstract

Background: Atrial fibrillation (AF) is an arrhythmia that can be difficult to identify and classify with short-term monitoring. However, current standard of practice requires only short-term monitoring to determine AF classifications and identify symptom-arrhythmia correlations prior to AF ablation procedures. Insertable cardiac monitors (ICMs) offer continuous arrhythmia monitoring, which could lead to a more accurate measurement of AF burden than standard of practice. Methods: This analysis focused on 121 patients enrolled in the LINQ Usability Study indicated for an AF ablation. Patients were followed for up to 1 year after ICM insertion. Clinical AF classifications were made by physicians prior to ICM implantation based on available clinical information. Device-detected AF burden and maximum daily burden were collected from device interrogations and remote transmissions. Device AF classifications were determined by categorizing the AF burden based on guidelines. Results: Agreement between clinical and device AF classifications preablation was poor (48.3%, N = 58). The strongest agreement was in the paroxysmal AF group but still was only 61.8%. Furthermore, device-detected preablation AF burden led to the decision to defer AF ablation procedures in 16 (13.2%) patients. The median AF burden in patients with ≥6 months follow-up postablation (n = 71) was reduced from 7.8% (interquartile range [IQR]: 0–32.1%) to 0% (IQR: 0–0.7%). Conclusions: ICM monitoring to determine AF burden pre- and post-AF ablation may have clinical utility for management of ablation candidates through more accurate AF classification and guiding treatment decisions.

Original languageEnglish
Pages (from-to)805-813
Number of pages9
JournalPacing and Clinical Electrophysiology : PACE
Volume39
Issue number8
DOIs
Publication statusPublished - 1 Aug 2016

Keywords

  • ablation
  • atrial fibrillation
  • insertable cardiac monitor

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