Key result
Patch ECG monitoring linked to ~56% lower detected atrial arrhythmia recurrence vs. continuous monitoring.
Why the study?
Effective monitoring of AF recurrence after catheter ablation is crucial, but comparisons of the effectiveness of different monitoring strategies remain underexplored.
Does continuous ECG monitoring detect more atrial arrhythmia recurrences than 7-14 day patch ECG monitoring in patients following radiofrequency catheter ablation for atrial fibrillation?
Observational (n=2,263)
Yes
Does continuous ECG monitoring detect more atrial arrhythmia recurrences than 7-14 day patch ECG monitoring in patients following radiofrequency catheter ablation for atrial fibrillation?
Continuous monitoring following AF catheter ablation detects atrial arrhythmias significantly more often than traditional patch ECG monitoring, suggesting it provides a more accurate assessment of ablation efficacy.
Continuous monitoring detected more recurrences than patch; leaves open whether it should guide post-ablation follow-up or change practice.
Background Effective monitoring of atrial fibrillation (AF) recurrence following catheter ablation is crucial for optimizing patient outcomes. Various monitoring strategies exist, but effectiveness comparisons remain underexplored. Objective This study compares the recurrence of atrial arrhythmias detected by continuous versus patch ECG monitoring methods following radiofrequency ablation (RFA) for AF. Methods Real‐world data from the REAL‐AF Registry (NCT 04088071) were analyzed. REAL‐AF is a prospective, observational, multicenter registry and this analysis included patients with available 12‐month follow‐up post‐RFA. We compared the detected recurrence rates of all‐atrial arrhythmias from continuous monitoring insertable cardiac monitors (ICMs), dual‐chamber pacemakers, and implantable cardioverter defibrillator (ICDs) or from patch ECG monitoring for 7–14‐days. Results Out of 2263 patients, 688 (30.4%) were monitored continuously, and 1575 (69.6%) were monitored with patch ECGs. The detected recurrence rate of all atrial arrhythmias was significantly higher in the continuous monitoring group compared to the patch monitoring group at 12 months (28.1% and 13.5%, p < 0.001, respectively). This difference remained significant after adjusting for confounding factors such as age, type of AF, CHA 2 DS 2 ‐VASc score, and left ventricular ejection fraction (HR = 0.44, 95% CI [0.35, 0.56], p < 0.001). Conclusion Continuous monitoring is associated with a higher detection rate of atrial arrhythmia recurrences following AF catheter ablation. These findings suggest that continuous monitoring should be considered the standard of care, especially in evaluating new ablation strategies and technologies.
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Mareddy et al. (2026) conducted an observational in Symptomatic paroxysmal or persistent atrial fibrillation (n=2,263). Continuous ECG monitoring (insertable cardiac monitors, dual-chamber pacemakers, implantable cardioverter defibrillators) vs. Intermittent patch ECG monitoring for 7-14 days was evaluated on Detected recurrence of all-atrial arrhythmias at 12 months (HR 0.44, 95% CI 0.35-0.56, p=<0.001). Continuous ECG monitoring detected a significantly higher rate of atrial arrhythmia recurrence compared to patch monitoring at 12 months (28.1% vs 13.5%, HR 0.44, p<0.001).
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