Tosho Balabanski1, Josep Brugada2, Elena Arbelo3, Cécile Laroche4, Aldo Maggioni4,5, Carina Blomström-Lundqvist6, Josef Kautzner7, Luigi Tavazzi8, Massimo Tritto9, Piotr Kulakowski10, Oskars Kalejs11, Tamas Forster12, Federico Segura Villalobos13, Nikolaos Dagres14. 1. Department of Electrophysiology, National Heart Hospital, 65 Konyovitza Street, 1309 Sofia, Bulgaria. 2. Cardiovascular Institute, Hospital Clínic Pediatric Arrhythmia Unit, Hospital Sant Joan de Déu University of Barcelona, Barcelona, Spain. 3. Department of Cardiology, Cardiovascular Institute, Hospital Clinic de Barcelona, Universitat de Barcelona, Spain, Institut d'Investigació August Pi i Sunyer (IDIBAPS), Barcelona, Spain, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. 4. EURObservational Research Programme (EORP), Scientific Division, European Society of Cardiology, Sophia-Antipolis, France. 5. ANMCO Research Center, Florence, Italy. 6. Department of Medical Science and Cardiology, Uppsala University, Uppsala, Sweden. 7. Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic. 8. Maria Cecilia Hospital, GVM Care & Research, Cotignola, Ravenna, Italy. 9. Humanitas Mater Domini Hospital, Castellanza, Italy. 10. Department of Cardiology, Grochowski Hospital Postgraduate Medical School, Warsaw, Poland. 11. Pauls Stradins Clinical University Hospital, Latvian Centre, of Cardiology, Riga, Latvia. 12. 2nd Department of Medicine and Cardiology Center, University of Szeged, Szeged, Hungary. 13. Hospital Universitario Insular de Gran Canaria, Cardiology, Las Palmas de Gran Canaria, Spain. 14. Department of Electrophysiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany.
Abstract
AIMS: Monitoring of patients after ablation had wide variations in the ESC-EHRA atrial fibrillation ablation long-term (AFA-LT) registry. We aimed to compare four different monitoring strategies after catheter AF ablation. METHODS AND RESULTS: The ESC-EHRA AFA-LT registry included 3593 patients who underwent ablation. Arrhythmia monitoring during follow-up was performed by 12-lead electrocardiogram (ECG), Holter ECG, trans-telephonic ECG monitoring (TTMON), or an implanted cardiac monitoring (ICM) system. Patients were selected to a given monitoring group according to the most extensive ECG tool used in each of them. Comparison of the probability of freedom from recurrences was performed by censored log-rank test and presented by Kaplan-Meier curves. The rhythm monitoring methods were used among 2658 patients: ECG (N = 578), Holter ECG (N = 1874), TTMON (N = 101), and ICM (N = 105). A total of 767 of 2658 patients (28.9%) had AF recurrences during follow-up. Censored log-rank test discovered a lower probability of freedom from relapses, which was detected with ICM compared to TTMON, ECG, and Holter ECG (P < 0.001). The rate of freedom from AF recurrences was 50.5% among patients using the ICM while it was 65.4%, 70.6%, and 72.8% using the TTMON, ECG, and Holter ECG, respectively. CONCLUSION: Comparing all main electrocardiographic monitoring methods in a large patient sample, our results suggest that post-ablation recurrences of AF are significantly underreported by TTMON, ECG, and Holter ECG. The ICM estimates AF ablation recurrences most reliably and should be a preferred mode of monitoring for trials evaluating novel AF ablation techniques. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Monitoring of patients after ablation had wide variations in the ESC-EHRA atrial fibrillation ablation long-term (AFA-LT) registry. We aimed to compare four different monitoring strategies after catheter AF ablation. METHODS AND RESULTS: The ESC-EHRA AFA-LT registry included 3593 patients who underwent ablation. Arrhythmia monitoring during follow-up was performed by 12-lead electrocardiogram (ECG), Holter ECG, trans-telephonic ECG monitoring (TTMON), or an implanted cardiac monitoring (ICM) system. Patients were selected to a given monitoring group according to the most extensive ECG tool used in each of them. Comparison of the probability of freedom from recurrences was performed by censored log-rank test and presented by Kaplan-Meier curves. The rhythm monitoring methods were used among 2658 patients: ECG (N = 578), Holter ECG (N = 1874), TTMON (N = 101), and ICM (N = 105). A total of 767 of 2658 patients (28.9%) had AF recurrences during follow-up. Censored log-rank test discovered a lower probability of freedom from relapses, which was detected with ICM compared to TTMON, ECG, and Holter ECG (P < 0.001). The rate of freedom from AF recurrences was 50.5% among patients using the ICM while it was 65.4%, 70.6%, and 72.8% using the TTMON, ECG, and Holter ECG, respectively. CONCLUSION: Comparing all main electrocardiographic monitoring methods in a large patient sample, our results suggest that post-ablation recurrences of AF are significantly underreported by TTMON, ECG, and Holter ECG. The ICM estimates AF ablation recurrences most reliably and should be a preferred mode of monitoring for trials evaluating novel AF ablation techniques. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Moussa C Mansour; Emily M Gillen; Audrey Garman; Sarah C Rosemas; Noreli Franco; Paul D Ziegler; Jesse M Pines Journal: Heart Rhythm O2 Date: 2022-01-07
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Authors: Shouvik Haldar; Habib Rehman Khan; Vennela Boyalla; Ines Kralj-Hans; Simon Jones; Joanne Lord; Oluchukwu Onyimadu; Anitha Satishkumar; Toufan Bahrami; Anthony De Souza; Jonathan R Clague; Darrel P Francis; Wajid Hussain; Julian W Jarman; David Gareth Jones; Zhong Chen; Neeraj Mediratta; Jonathan Hyde; Michael Lewis; Raad Mohiaddin; Tushar V Salukhe; Caroline Murphy; Joanna Kelly; Rajdeep S Khattar; William D Toff; Vias Markides; James McCready; Dhiraj Gupta; Tom Wong Journal: Eur Heart J Date: 2020-12-14 Impact factor: 29.983