Continuous Cardiac Monitoring around Atrial Fibrillation Ablation: Insights on Clinical Classifications and End Points

Dekker, Lukas; Pokushalov, Evgeny; Sanders, Prashanthan; Lindborg, Katherine A.; Maus, Bärbel; Pürerfellner, Helmut

doi:10.1111/pace.12897

Cited by 12 publications

(8 citation statements)

References 36 publications

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“…19 ). Finally, monitoring with ILR has an advantage of continuous application for a much longer time 14,[20][21][22][23][24] . However; limited memory for real ECG data with storing of overwritten files as frequency histograms has been only partly solved by implementing once-a-day automatic transtelephonic data transmission specifically in asymptomatic patients who may not activate transfer of all necessary ECG recordings.…”

Section: Discussionmentioning

confidence: 99%

Comparison of two modes of long-term ECG monitoring to assess the efficacy of catheter ablation for paroxysmal atrial fibrillation

Chovančík

Bůlková²,

Wichterle

et al. 2019

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims. Optimal ECG monitoring in detecting recurrences of atrial fibrillation (AF) or atrial tachycardia (AT) after catheter ablation has not been well established. The purpose of this prospective study was to compare the utility of daily ECG monitoring with episodic card recorder (ECR) vs. periodic monitoring with episodic loop recorder (ELR) for the detection of post-blanking AF/AT recurrences during early (Months 4-6) and late (Months 7-12) periods after catheter ablation for paroxysmal AF. Methods. The study included 105 consecutive patients, who received ECR for 12 months and were instructed to send at least 2 random ECG recordings daily with extra-recordings during symptoms. The patients were simultaneously monitored for one week with ELR at the end of each period (Months 6 and 12). Results. Thirty-one and 12 patients with AF/AT recurrence were identified by means of ECR and ELR, respectively. In patients with complete and valid data, ELR technology was inferior to ECR by detecting AF/AT in 5 (31%) of 16 and 5 (26%) of 19 patients with arrhythmia identified by ECR in the early and late period, respectively. Overall, ELR had a sensitivity of 8/23 (35%) for detecting AF/AT recurrence. There was no single patient with AF/AT recurrence on ELR that would not be known from ECR monitoring. Only 2 patients with arrhythmia recurrence were completely asymptomatic throughout the study period. Conclusion. Daily ECG monitoring with ECR was better than periodic monitoring with ELR in detecting AF/AT recurrences during the follow-up periods. Entirely asymptomatic patients with AF/AT recurrences were rare.

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Section: Discussionmentioning

confidence: 99%

Comparison of two modes of long-term ECG monitoring to assess the efficacy of catheter ablation for paroxysmal atrial fibrillation

Chovančík

Bůlková²,

Wichterle

et al. 2019

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…The majority of the patients in both groups understood that poor correlation between AF symptoms and AF episodes 16,38,39 was a reason to use AliveCor to identify their true cardiac rhythm. Many engaged patients appropriately considered their actual ECG data versus their symptoms in determining whether to continue using AliveCor.…”

Section: Af Symptoms: Driving Use For Unengaged Patientsmentioning

confidence: 99%

“…Evidence shows that AF episodes frequently do not correlate with perceived symptoms. 16,38,39 Patients may be asymptomatic or experience vague symptoms that mimic those of comorbid conditions, and the type and severity of systems may change over time, which would necessitate continued use.…”

Section: Implications For Researchmentioning

confidence: 99%

Factors Influencing Sustained Engagement with ECG Self-Monitoring: Perspectives from Patients and Health Care Providers

et al. 2018

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Keywords► patient engagement ► patient-provider communication ► workflows and human interactions ► smart phone ► mobile platforms ► general information systems and technologies in clinics ► consumer health informatics AbstractBackground Patient-generated health data (PGHD) collected digitally with mobile health (mHealth) technology has garnered recent excitement for its potential to improve precision management of chronic conditions such as atrial fibrillation (AF), a common cardiac arrhythmia. However, sustained engagement is a major barrier to collection of PGHD. Little is known about barriers to sustained engagement or strategies to intervene upon engagement through application design.Objective This article investigates individual patient differences in sustained engagement among individuals with a history of AF who are self-monitoring using mHealth technology. Methods This qualitative study involved patients, health care providers, and research coordinators previously involved in a randomized, controlled trial involving electrocardiogram (ECG) self-monitoring of AF. Patients were adults with a history of AF randomized to the intervention arm of this trial who self-monitored using ECG mHealth technology for 6 months. Semistructured interviews and focus groups were conducted separately with health care providers and research coordinators, engaged patients, and unengaged patients. A validated model of sustained engagement, an adapted unified theory of acceptance and use of technology (UTAUT), guided data collection, and analysis through directed content analysis.Results We interviewed 13 patients (7 engaged, 6 unengaged), 6 providers, and 2 research coordinators. In addition to finding differences between engaged and unengaged patients within each predictor in the adapted UTAUT model (perceived ease of use, perceived usefulness, facilitating conditions), four additional factors were identified as being related to sustained engagement in this population. These are: (1) internal motivation to manage health, (2) relationship with health care provider, (3) supportive environments, and (4) feedback and guidance. Conclusion Although it required some modification, the adapted UTAUT model was useful in understanding of the parameters of sustained engagement. The findings of this study provide initial requirement specifications for the design of applications that engage patients in this unique population of adults with AF.

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“…Clinical trials have demonstrated that the LINQ adequately detects AF and may even be more accurate in classifying AF as compared with short-term monitoring devices (Holter monitor, extended cardiac monitoring). 10,13,31 The LINQ is also highly sensitive in detecting AF duration among patients with a history of paroxysmal AF. 11…”

Section: Rm Technologies To Detect Afmentioning

confidence: 99%

“…These monitoring approaches often fail to capture AF when episodes are not frequent, and thus, are not captured within the monitoring period. 12,13…”

mentioning

confidence: 99%

Detection and management of atrial fibrillation using remote monitoring

Hickey

Riga

Mitha

et al. 2018

The Nurse Practitioner

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Continuous Cardiac Monitoring around Atrial Fibrillation Ablation: Insights on Clinical Classifications and End Points

Abstract: ICM monitoring to determine AF burden pre- and post-AF ablation may have clinical utility for management of ablation candidates through more accurate AF classification and guiding treatment decisions.

Cited by 12 publications

References 36 publications

Comparison of two modes of long-term ECG monitoring to assess the efficacy of catheter ablation for paroxysmal atrial fibrillation

Comparison of two modes of long-term ECG monitoring to assess the efficacy of catheter ablation for paroxysmal atrial fibrillation

Factors Influencing Sustained Engagement with ECG Self-Monitoring: Perspectives from Patients and Health Care Providers

Detection and management of atrial fibrillation using remote monitoring

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