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Impact of monitoring on detection of arrhythmia recurrences in the ESC-EHRA EORP atrial fibrillation ablation long-term registry
- Balabanski, Tosho (author)
- Brugada, Josep (author)
- Arbelo, Elena (author)
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- Laroche, Cécile (author)
- Maggioni, Aldo (author)
- Kautzner, Josef (author)
- Tavazzi, Luigi (author)
- Tritto, Massimo (author)
- Kulakowski, Piotr (author)
- Kalejs, Oskars (author)
- Forster, Tamas (author)
- Villalobos, Federico Segura (author)
- Dagres, Nikolaos (author)
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- (creator_code:org_t)
- 2019-08-13
- 2019
- English.
- In: Europace. - : Oxford University Press. - 1099-5129 .- 1532-2092. ; 21:12, s. 1802-1808
- Journal article (peer-reviewed)
Abstract
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Ablation
- Atrial fibrillation
- EHRA registry
- Recurrence
- Rhythm monitoring
Publication and Content Type
- ref (subject category)
- art (subject category)
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- Brugada, Josep
- Arbelo, Elena
- Laroche, Cécile
- Maggioni, Aldo
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- Kautzner, Josef
- Tavazzi, Luigi
- Tritto, Massimo
- Kulakowski, Piot ...
- Kalejs, Oskars
- Forster, Tamas
- Villalobos, Fede ...
- Dagres, Nikolaos
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- Europace
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- Uppsala University
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