Symptomatic and Asymptomatic Atrial Fibrillation in Patients Undergoing Radiofrequency Catheter Ablation

Authors


  • This work was presented at American College of Cardiology annual scientific session March 6–9, 2005 in Orlando, Florida. Dr. Vasamreddy was partially supported by the Norbert and Louise Grunwald Cardiac Arrhythmia Research Fund.

  • This article was processed by a guest editor.

  • Manuscript received 28 July 2005; Revised manuscript received 25 September 2005; Accepted for publication 3 October 2005.

Address for correspondence: Hugh Calkins, M.D., The Johns Hopkins Hospital, 600 North Wolfe Street, Carnegie 592, Baltimore, MD 21287-0409. Fax: 410-614-1345; Email: hcalkins@jhmi.edu

Abstract

Introduction: The goals of this study were to (i) evaluate the feasibility and results of monitoring patients prior to and following catheter ablation of AF with the mobile cardiac outpatient telemetry (MCOT) system and to (ii) correlate symptoms and the presence or absence of atrial fibrillation (AF).

Methods and Results: A total of 19 consecutive patients (12 men [63%]; age 60 ± 6 years) with highly symptomatic drug refractory AF underwent catheter ablation. Each was provided with a MCOT monitor (CardioNet, USA) and asked to wear it 5 days immediately before the ablation, and 5 days per month starting with the ablation for 6 consecutive months. When patients experienced any symptoms, they were asked to activate the system and to record associated symptoms. A total of 494 days (11,856 hours) were monitored. Out of the total 390 events triggered by patient's symptoms, 40% were confirmed as AF events (156) and 60% were confirmed as non-AF events (234). Only shortness of breath and chest discomfort were highly associated with AF (P < 0.05). At the end of 6 months of follow-up, out of 10 patients that completed the study, 7 (70%) patients were free of symptomatic AF recurrences whereas only 5 (50%) patients achieved success when asymptomatic AF recurrences were included in the outcome.

Conclusions: The results of this study demonstrate the potential utility of wireless monitoring systems in the follow-up of AF ablation patients, while also identifying poor patient compliance with an intensive monitoring protocol as an important limitation.

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