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Recurrent atrial fibrillation/flutter detection after ablation or cardioversion using the AliveCor KardiaMobile

Isaac L Goldenthal1, Robert R Sciacca2, Teresa Riga1

  • 1Department of Medicine - Cardiology, Columbia University Irving Medical Center, New York, New York.

Journal of Cardiovascular Electrophysiology
|September 12, 2019
PubMed

Insights

Daily mobile electrocardiogram (ECG) self-recordings led to earlier detection of atrial fibrillation (AF) or atrial flutter (AFL) recurrence after treatment. This approach may also empower patients in shared decision-making for arrhythmia management.

Area of Science:

  • Cardiology
  • Digital Health
  • Medical Devices

Background:

  • Atrial fibrillation (AF) and atrial flutter (AFL) have high recurrence rates after treatment (20-45% for RFA, 60-80% for DCCV).
  • Limited randomized trials exist comparing mobile ECG devices to standard care for post-treatment AF/AFL monitoring.

Purpose of the Study:

  • To evaluate the impact of daily ECG self-recordings on the time to documented recurrent AF/AFL.
  • To assess the effect on time to treatment for recurrent arrhythmias in patients post-catheter radiofrequency ablation (RFA) or direct current cardioversion (DCCV).

Main Methods:

  • 238 patients were randomized to standard care or the iHEART intervention (daily mobile ECG recordings).
  • Intervention group used AliveCor KardiaMobile ECG devices for daily self-recording and transmission.
  • Data collected from ECGs and electronic health records.

Main Results:

  • The intervention group showed a greater likelihood of recurrence detection (HR=1.56, P=0.024).
  • Early recurrence (within the first month) strongly predicted later recurrence (HR=4.53, P=0.0006).
  • Time from detection to treatment was shorter in the control group (HR=0.33, P<0.0001).

Conclusions:

  • Mobile ECG self-recording facilitates earlier detection of AF/AFL recurrence.
  • This technology can empower patients in shared health decision-making regarding their arrhythmia management.
Abstract

Keywords:
Holter/event recordersatrial arrhythmiasatrial fibrillationatrial fluttercardioversion

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