Continuous Cardiac Monitoring around Atrial Fibrillation Ablation: Insights on Clinical Classifications and End Points
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...
Saved in:
Published in | Pacing and clinical electrophysiology Vol. 39; no. 8; pp. 805 - 813 |
---|---|
Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Blackwell Publishing Ltd
01.08.2016
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | 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. |
---|---|
Bibliography: | St. Jude Medical ark:/67375/WNG-0X2L13L5-9 Medtronic Biotronik istex:BCC5505F0079C3614D7623A042009DD2F909E274 Boston Scientific ArticleID:PACE12897 Disclosures: L. Dekker reports having received consultancy fees from Medtronic and St. Jude Medical, and research support from Medtronic, St. Jude Medical, and Philips. E. Pokushalov reports having received honoraria from Medtronic, Biosense Webster, and Boston Scientific. P. Sanders reports having served on the advisory board of Biosense Webster, Medtronic, St. Jude Medical, Boston Scientific, and CathRx; having received lecture fees from Biosense Webster, Medtronic, St. Jude Medical, and Boston Scientific; and having received research funding from Medtronic, St. Jude Medical, Boston Scientific, Biotronik, and Sorin. K. Lindborg and B. Maus are Medtronic employees and shareholders. H. Pürerfellner reports having received consultancy fees from Medtronic, St. Jude Medical, and Biosense Webster and honoraria from St. Jude Medical, Biosense Webster, Sanofi, Daiichi‐Sankyo, Böhringer‐Ingelheim, and Bristol‐Myers Squibb. ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2 |
ISSN: | 0147-8389 1540-8159 |
DOI: | 10.1111/pace.12897 |