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Robotic Ablation of Atrial Fibrillation
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Burden-based outcomes after atrial fibrillation ablation: A 4-year continuous monitoring study

Alexandre Almorad1, Milad El Haddad2, Mehdi El Channan2

  • 1Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel, Heart Rhythm Research Brussels, Postgraduate Program in Cardiac Electrophysiology and Pacing, Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium; Department of Cardiology, Centre Universitaire St Pierre Bruxelles, Brussels, Belgium.

Heart Rhythm
|January 23, 2026
PubMed

Insights

Catheter ablation significantly reduces atrial tachyarrhythmia burden for up to four years, improving quality of life. Continuous monitoring is key, though intermittent sampling shows promise.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Atrial fibrillation (AF) significantly impacts patient quality of life (QoL) and healthcare costs.
  • Long-term outcomes of catheter ablation (CA) for AF, especially with continuous rhythm monitoring, require further characterization.

Purpose of the Study:

  • To assess atrial tachyarrhythmia burden (ATaB) using implantable cardiac monitors (ICMs) before and up to 4 years post-CA.
  • To evaluate the association between ATaB reduction and QoL.
  • To explore the efficacy of simulated intermittent monitoring (Burden-by-Sampling, BBS) in approximating ICM-derived ATaB.

Main Methods:

  • Prospective cohort study of 165 patients undergoing first-time CA for AF.
  • Continuous ATaB monitoring via ICMs for up to 4 years.
  • Annual QoL assessments using SF-36 and AF-specific questionnaires; retrospective BBS simulations.

Main Results:

  • Median follow-up of 40.9 months.
  • Significant reduction in median ATaB from 15% to 0% (p<0.001).
  • Sustained QoL improvements observed up to 4 years post-ablation.

Conclusions:

  • Catheter ablation provides durable, substantial ATaB reduction and sustained QoL benefits over 4 years.
  • Findings support patient-centered, burden-based endpoints over binary success definitions.
  • Intermittent monitoring via BBS shows potential but needs prospective validation.
Abstract

Keywords:
Atrial fibrillationAtrial fibrillation burdenBurden-by-samplingInsertable cardiac monitorLong-term follow-upPulmonary vein isolationRecurrence

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