Does intermittent rhythm monitoring accurately estimate true atrial fibrillation burden compared to continuous monitoring in patients with AF?
Intermittent rhythm monitoring provides unreliable estimates of true atrial fibrillation burden, particularly in paroxysmal AF, and should not be used to evaluate outcomes after AF interventions.
BACKGROUND: Estimates of atrial fibrillation (AF) burden (AFB) derived from intermittent rhythm monitoring (IRM) are increasingly being used as an outcome measure after therapeutic interventions; however, their accuracy has never been validated. The aim of this study was to compare IRM-derived AFB estimates to the true AFB as measured by implantable continuous monitoring (CM) devices. METHODS: Rhythm histories from 647 patients (mean AFB: 12 ± 22%; 687 patient·years) with CM devices were analyzed. IRM of various frequencies and durations were simulated and the obtained IRM-derived AF burdens were compared to the true AFB measured by CM. RESULTS: The relative error of the IRM burden estimates was dependent on the IRM length (P 80% of the true AFB. The relative error decreased with higher true AF burdens, lower AF densities, and higher IRM frequency or duration (P 20%, P < 0.001) and resulted in a substantial measurement error. CONCLUSION: IRM-derived AFB estimates are unreliable estimators of the true AFB. Particularly for paroxysmal AF patients, IRM-derived AFB estimates should not be used to evaluate outcomes after AF interventions.
Charitos et al. (Tue,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: