Symptom severity assessment in patients with atrial fibrillation after catheter ablation using a smartphone application
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Updated: Jun 16, 2026

Patient Directed Recording of a Bipolar Three-Lead Electrocardiogram using a Smartwatch with ECG Function
Published on: December 11, 2019
Emma Sandgren1,2, Konstanze Betz1,3, Monika Gawalko1,4,5
1Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, P.Debyelaan 25, Maastricht 6229 HX, the Netherlands.
Aims:
Symptom severity in atrial fibrillation (AF) influences healthcare use, but conventional assessments lack temporal precision. We evaluated the feasibility of smartphone-based symptom severity assessment after AF catheter ablation and explored predictors and variability of symptom severity.
Methods And Results:
In this analysis of the ISOLATION study, 140 patients used a photoplethysmography-supported smartphone application to record heart rhythm, symptoms, and symptom severity three times daily and when symptomatic for 7 days at 3, 6, and 12 months after ablation. Symptom severity was classified using the modified European Heart Rhythm Association scale. A total of 8575 recordings were analysed, of which 11% showed AF. Median adherence was 67%. Symptom severity was higher during AF, in women, and with higher heart rate. Nearly half of AF recordings were asymptomatic.
Conclusion:
Smartphone-based symptom severity assessment after AF ablation is feasible and reveals substantial individual variability beyond rhythm status alone.
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