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Rhythm Control and its Relation to Symptoms During the First Two Years After Radiofrequency Ablation for Atrial Fibrillation
Örebro University, School of Health Sciences. Department of Cardiology.
Department of Cardiology, Odense University Hospital, Odense, Denmark.
Department of Cardiology, Odense University Hospital, Odense, Denmark.
Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
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2016 (English)In: Pacing and Clinical Electrophysiology, ISSN 0147-8389, E-ISSN 1540-8159, Vol. 39, no 9, 914-925 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate rhythm control up to two years after AF ablation and its relation to reported symptoms.

Background: The implantable loop recorder (ILR) continuously records the ECG, has an automatic AF detection algorithm and a possibility for patients to activate an ECG recording during symptoms.

Methods: Fifty-seven patients (mean age 57±9 years, 60% male, 88% paroxysmal AF) underwent AF ablation following ILR implantation. Device data were downloaded at the ablation and three, six, 12, 18 and 24 months after ablation.

Results: Fifty-four patients completed the two-year follow-up. Thirteen (24%) patients had no AF episodes detected by ILR during follow-up. Ten of 41 patients (24%) with AF recurrence were only detected by ILR and AF recurrences were detected earlier by ILR (P<0.001). The median AF burden in patients with AF recurrence was 5.7% (IQR 0.4-14.4) and was even lower in patients with AF only detected by ILR (P = 0.001). Forty-eight % of the patients indicated symptoms via the patient activator but 33% of those recordings were not due to AF. Early AF recurrence (within 3 months) was highly associated with later AF recurrence (P<0.001). AF burden >0.5% and longest >6h before the ablation were independent predictors of AF recurrence during intermittent but not continuous monitoring.

Conclusions: After AF ablation, the AF burden was low throughout the 24 months follow-up. Nevertheless, symptoms were commonly indicated but one third of patient activated recordings did not show AF. Continuous monitoring was superior to intermittent follow-up in detecting AF episodes and assessing the AF burden.

Clinical trial registration: URL: http://clinicaltrials.gov. Unique Identifier: NCT00697359.

Place, publisher, year, edition, pages
Hoboken, USA: Wiley-Blackwell Publishing Inc., 2016. Vol. 39, no 9, 914-925 p.
Keyword [en]
Atrial fibrillation, catheter ablation, implantable loop recorder, monitoring, symptoms
National Category
Cardiac and Cardiovascular Systems
Research subject
Cardiology
Identifiers
URN: urn:nbn:se:oru:diva-51530DOI: 10.1111/pace.12916ISI: 000383572900002PubMedID: 27418324Scopus ID: 2-s2.0-84987723704OAI: oai:DiVA.org:oru-51530DiVA: diva2:950980
Note

Funding Agencies:

Medtronic

Örebro heart foundation

Research Committee of Örebro University Hospital, Örebro, Sweden

Available from: 2016-08-04 Created: 2016-08-02 Last updated: 2016-11-21Bibliographically approved

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