Why the study?
The study was conducted to examine the impact of additionally using a home electrocardiograph to detect atrial fibrillation recurrence after ablation.
Does daily home ECG measurement improve the detection of atrial fibrillation recurrence in patients after ablation compared to usual care?
Does daily home ECG measurement improve the detection of atrial fibrillation recurrence in patients after ablation compared to usual care?
Daily home ECG monitoring significantly increases and accelerates the detection of atrial fibrillation recurrence after ablation compared to standard intermittent monitoring, especially in highly adherent patients.
May warrant intensified post-ablation monitoring in adherent patients; leaves open impact on outcomes and need for randomized trials.
Background: This multicenter prospective observational study examined the impact of additionally using a home electrocardiograph (ECG) to detect atrial fibrillation (AF) recurrence after ablation. Methods: Between May 2019 and December 2020, 128 patients undergoing ablation were enrolled in the study. After performing ablation, they were instructed to measure their ECGs at home using Complete (ECG paired with a blood pressure monitor; Omron Healthcare, Japan) every day and to visit the hospital every 3 months until after 12 months for 24-hour Holter ECG and 12-lead ECG as usual care (UC). Results: After ablation, 94 patients were followed up, and AF recurrence at 12 months was detected more commonly in adjudicators-interpreted Complete (31 [33 %]) than in UC (18 [9 %]) (hazard ratio 1.95, 95 % confidence interval [95 %CI] 1.35-2.81, P < 0.001). In patients with recurrent AF found via both modalities (n = 16), the time to first AF detection by Complete was 40.9 ± 73.9 days faster than that in UC (P = 0.04). Notably, when the adherence to Complete measurement was divided by 80 %, the add-on effect of Complete on the detection of recurrent AF in UC indicated the hazard ratio (HR) of 1.71 (95 %CI 0.92-3.18, P = 0.09) for the low adherence (<80 %) group, but it was significant for the high adherence (≥80 %) group, with HR of 2.19 (95 %CI 1.43-3.36, P < 0.001). Conclusions: Despite a shorter measurement time, Complete detected recurrent AF more frequently and faster compared with UC after AF ablation. A significant adherence-dependent difference of Complete was found in detecting AF recurrence.
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Senoo et al. (2023) studied this question.
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