Extended 14-day external loop recorder monitoring improved detection of atrial tachyarrhythmia recurrence after AF ablation, with 24-hour monitoring showing only 27.7% relative sensitivity.
Observational (n=342)
Does 14-day extended external auto-triggered loop recorder monitoring improve detection of recurrent atrial tachyarrhythmia compared to 24-hour Holter monitoring in patients after atrial fibrillation ablation?
Extended 14-day monitoring with an auto-triggered external loop recorder significantly increases the detection of recurrent, often asymptomatic, atrial tachyarrhythmias after AF ablation compared to standard 24-hour Holter monitoring.
BACKGROUND: Clinical outcomes after atrial fibrillation (AF) ablation are evaluated using standard 24-h Holter monitoring, and the large spontaneous variability of AF episodes and incidence of silent AF are major limitations. Further, symptoms generally decrease after AF ablation. METHODS AND RESULTS: Newly developed extended external auto-trigger loop recorders (ELR) were used for 14-day consecutive monitoring to detect atrial tachyarrhythmia (ATa). Continuous tracings were stored for the initial 24h. Among 500 examinations after AF ablation in 342 patients, 40 ATa episodes were manually detected in 25 patients during the initial 24h. All episodes including 27 asymptomatic episodes (67.5%) were successfully identified using ELR. Recurrent ATa after AF ablation were detected in 83 patients, and a median monitoring duration of 4.0 days (IQR, 1.0-7.75 days) was required to detect the first episode of recurrence. The sensitivity of 24-h monitoring in detecting arrhythmia recurrence was 27.7% relative to the 14-day monitoring. The diagnostic yield gradually improved with longer monitoring duration regardless of the period after the ablation procedure. Longer follow-up, however, was required to obtain similar diagnostic yield >1 year after as compared to <1 year after the procedure. CONCLUSIONS: Twenty-four-hour monitoring detected a part of the ATa recurrences after ablation procedures. Extended ELR enabled arrhythmia monitoring for longer, with higher diagnostic yield of recurrence, regardless of patient symptoms.
Takagi et al. (Wed,) conducted a observational in Atrial fibrillation after ablation (n=342). Extended external auto-trigger loop recorder (ELR) vs. 24-hour Holter monitoring was evaluated on Detection of atrial tachyarrhythmia recurrence. Extended 14-day external loop recorder monitoring improved detection of atrial tachyarrhythmia recurrence after AF ablation, with 24-hour monitoring showing only 27.7% relative sensitivity.