The Future of Long-Term Monitoring Following Catheter and Surgical
Intervention for Atrial Fibrillation
Abstract
Monitoring following catheter or surgical ablation for atrial
fibrillation (AF) is an essential tool used to assess outcomes for
research purposes and help guide clinical decision making. The most
commonly used methods to monitor for post-intervention AF include a
variety of ambulatory external electrocardiogram (ECG) monitors, cardiac
implantable electronic devices (CIED), and more recently, direct to
consumer digital health technologies. The traditional metric of ablation
success, recurrence > 30 seconds at 1 year, is below the
detection capabilities of almost all monitoring techniques yet still
undervalues the efficacy of AF interventions. Measures of AF burden
reduction and duration give a more complete assessment of the impact of
AF surgeries and ablation. As it is increasingly being recognized that
AF burden and duration is related to stroke risk, long-term,
inexpensive, non-invasive monitoring methods are needed. Smart phones
and watches with AF-detecting capabilities, which are increasingly being
used by the majority of US adults, have emerged as viable options to
achieve this goal, shifting the paradigm of AF monitoring to a more
patient centered approach.