A 4-day Holter monitor at 12 months post-ablation achieved 88% sensitivity for detecting atrial fibrillation recurrence, compared to 53% for a 1-day Holter.
Cohort (n=96)
Does a 7-day Holter monitor improve the detection of arrhythmia recurrences compared to shorter monitoring durations in patients 12 months after PVI for paroxysmal AF?
A 4-day Holter monitor at 12 months post-PVI provides 88% sensitivity for detecting arrhythmia recurrences, offering a sufficient monitoring duration without significantly lower yield than a 7-day monitor.
Absolute Event Rate: 88% vs 53%
BACKGROUND: After pulmonary vein isolation (PVI), patients need to be followed to analyze the effect of the treatment. We evaluated the influence of the duration of Holter monitoring on the detection of arrhythmia recurrences after a single PVI at 12 months. METHODS: Consecutive patients with paroxysmal atrial fibrillation (AF) underwent successful PVI with phased radiofrequency and pulmonary vein ablation catheter. Follow-up was performed with electrocardiogram at 3, 6, and 12 months and 7-day Holter at 12 months. Symptomatic patients received additional event recording. The 7-day Holters at 12 months were evaluated for documented left atrial tachyarrhythmia recurrences, and each individual day with AF was categorized. RESULTS: At 12 months after the procedure, 21 of the 96 (22%) patients had AF on their 7-day Holter. In the patients with AF recurrence, there was an increase in sensitivity from 53% of a 1-day Holter up to 88% with 4-day Holter, and 100% of a 7-day Holter. Monitoring with duration of less than 4 days resulted in significantly less detection of patients with AF compared to 7-day Holter. CONCLUSIONS: A 4-day Holter at 12 months has an 88% sensitivity for arrhythmia detection, and appears to provide a sufficient monitoring time. Prolonging the monitoring time to 7 days does not significantly increase the yield.
Mulder et al. (Fri,) conducted a cohort in paroxysmal atrial fibrillation (n=96). 4-day Holter monitoring vs. 1-day Holter monitoring was evaluated on Sensitivity for detection of atrial fibrillation recurrence. A 4-day Holter monitor at 12 months post-ablation achieved 88% sensitivity for detecting atrial fibrillation recurrence, compared to 53% for a 1-day Holter.