Comparison of continuous versus intermittent monitoring of atrial arrhythmias

Ziegler, Paul; Koehler, Jodi; Mehra, Rahul

doi:10.1016/j.hrthm.2006.07.030

Cited by 262 publications

(171 citation statements)

References 21 publications

Supporting

Mentioning

162

Contrasting

Unclassified

Order By: Relevance

“…If the goal is to restore sinus rhythm, then more intense monitoring with long-term monitoring is appropriate [24][25][26]. On the other hand, if the goal is symptom control, less intensive monitoring may be adequate [24,27].…”

Section: Discussionmentioning

confidence: 99%

“…Our study showed more intensive monitoring by electrophysiologists compared to cardiologists in patients treated with a rate control strategy. This practice may be useful for assessing the burden of AF in asymptomatic patients [24], guide ventricular rate control, anticoagulation therapy and to guide further decisions to cross over to a rhythm control strategy [28]. Intensive monitoring will affect the number of patients with documented AF during follow-up [24][25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

“…This practice may be useful for assessing the burden of AF in asymptomatic patients [24], guide ventricular rate control, anticoagulation therapy and to guide further decisions to cross over to a rhythm control strategy [28]. Intensive monitoring will affect the number of patients with documented AF during follow-up [24][25][26][27][28]. Furthermore, increased use of amiodarone, which is a moderately effective antiarrhythmic drug [29,30], by cardiologists may have contributed to the lower proportion of documented AF on follow-up.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Atrial fibrillation practice patterns among cardiac electrophysiologists and cardiologists

Teme

Goldberger²

2014

Cardiol J

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Atrial fibrillation practice patterns among cardiac electrophysiologists and cardiologists

Teme

Goldberger²

2014

Cardiol J

View full text Add to dashboard Cite

show abstract

“…943,947,948,949 Conversely, the more complex and longer the method of monitoring used, the lower the patient compliance.…”

Section: Section 8: Follow-up Considerationsmentioning

confidence: 99%

“…Scheduled 7-day Holter ECG recordings or daily plus symptom-activated event recordings are estimated to document approximately 70% of AF recurrences, with an estimated negative predictive value for absence of AF between 25% and 40%. 947,1393 …”

Section: Section 13: Clinical Trial Designmentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

1,769

1,468

View full text Add to dashboard Cite

Effect of Catheter Ablation vs Antiarrhythmic Medication on Quality of Life in Patients With Atrial Fibrillation

Blomström‐Lundqvist

Gizurarson

Schwieler

et al. 2019

JAMA

278

179

View full text Add to dashboard Cite

is not a standard primary outcome in ablation trials, even though symptoms drive the indication. OBJECTIVE To assess quality of life with catheter ablation vs antiarrhythmic medication at 12 months in patients with atrial fibrillation. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial at 4 university hospitals in Sweden and 1 in Finland of 155 patients aged 30-70 years with more than 6 months of atrial fibrillation and treatment failure with 1 antiarrhythmic drug or β-blocker, with 4-year follow-up. Study dates were July 2008-September 2017. Major exclusions were ejection fraction <35%, left atrial diameter >60 mm, ventricular pacing dependency, and previous ablation. INTERVENTIONS Pulmonary vein isolation ablation (n = 79) or previously untested antiarrhythmic drugs (n = 76). MAIN OUTCOMES AND MEASURES Primary outcome was the General Health subscale score (Medical Outcomes Study 36-Item Short-Form Health Survey) at baseline and 12 months, assessed unblinded (range, 0 [worst] to 100 [best]). There were 26 secondary outcomes, including atrial fibrillation burden (% of time) from baseline to 12 months, measured by implantable cardiac monitors. The first 3 months were excluded from rhythm analysis. RESULTS Among 155 randomized patients (mean age, 56.1 years; 22.6% women), 97% completed the trial. Of 79 patients randomized to receive ablation, 75 underwent ablation, including 2 who crossed over to medication and 14 who underwent repeated ablation procedures. Of 76 patients randomized to receive antiarrhythmic medication, 74 received it, including 8 who crossed over to ablation and 43 for whom the first drug used failed. General Health score increased from 61.8 to 73.9 points in the ablation group vs 62.7 to 65.4 points in the medication group (between-group difference, 8.9 points; 95% CI, 3.1-14.7; P = .003). Of 26 secondary end points, 5 were analyzed; 2 were null and 2 were statistically significant, including decrease in atrial fibrillation burden (from 24.9% to 5.5% in the ablation group vs 23.3% to 11.5% in the medication group; difference-6.8% [95% CI,-12.9% to-0.7%]; P = .03). Of the Health Survey subscales, 5 of 7 improved significantly. Most common adverse events were urosepsis (5.1%) in the ablation group and atrial tachycardia (3.9%) in the medication group. CONCLUSIONS AND RELEVANCE Among patients with symptomatic atrial fibrillation despite use of antiarrhythmic medication, the improvement in quality of life at 12 months was greater for those treated with catheter ablation compared with antiarrhythmic medication. Although the study was limited by absence of blinding, catheter ablation may offer an advantage for quality of life.

show abstract

Comparison of continuous versus intermittent monitoring of atrial arrhythmias

Cited by 262 publications

References 21 publications

Atrial fibrillation practice patterns among cardiac electrophysiologists and cardiologists

Atrial fibrillation practice patterns among cardiac electrophysiologists and cardiologists

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Effect of Catheter Ablation vs Antiarrhythmic Medication on Quality of Life in Patients With Atrial Fibrillation

Contact Info

Product

Resources

About