What is the real atrial fibrillation burden after catheter ablation of atrial fibrillation? A prospective rhythm...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Device Technology

Background:

• Atrial fibrillation (AF) ablation follow-up traditionally relies on Holter ECG, tele-ECG, or patient symptoms.
• Previous studies indicate that shorter monitoring periods often miss asymptomatic AF recurrences.
• Pacemaker patients offer a unique opportunity for continuous atrial monitoring via integrated Holter functions.

Purpose of the Study:

• To analyze continuous atrial recordings in pacemaker patients before and after AF ablation.
• To accurately determine all AF recurrences and establish the true success rates of AF ablation.
• To compare rhythm follow-up data from integrated Holter functions with clinical evaluation.

Main Methods:

• Retrospective analysis of 37 pacemaker/ICD patients undergoing AF ablation.
• Utilized integrated atrial Holter function for continuous rhythm monitoring before and after ablation.
• Defined AF recurrence as atrial high-frequency episodes >30 seconds at >180 bpm.
• Correlated Holter data with patient symptoms throughout the follow-up period.

Main Results:

• AF burden significantly decreased post-ablation in both paroxysmal AF (PAF) and persistent AF (PersAF) groups (P < 0.001 and P = 0.024, respectively).
• Complete AF freedom was achieved in 85% of PAF patients and 59% of PersAF patients.
• Symptomatic status strongly correlated with documented freedom from AF, suggesting high clinical relevance.

Conclusions:

• Catheter ablation can achieve high rates of freedom from AF, including in patients with persistent AF.
• Continuous atrial monitoring in pacemaker patients provides a reliable method for assessing AF ablation success.
• Symptomatic improvement accurately reflects rhythm status post-ablation in this patient cohort.