Evaluación de la adherencia y la rentabilidad diagnóstica en detección de recurrencias tras ablación de fibrilación auricular mediante seguimiento con un dispositivo electrocardiograma portátil realizado por enfermería

Introduction and objective. The detection of atrial fibrillation recurrences after ablation is crucial, although most of them remain undetected. The aim of this study is to evaluate the diagnostic capability for detecting atrial fibrillation recurrences of an ECG portable device, followed by a nurse, and the patient‘s adherence to the device. Methods. We conducted a prospective observational study with patients included in the CAVAC-AF study, who received an ECG portable device. Patients were instructed to perform a daily and a symptom–guided electrocardiogram (extra electrocardiogram). Review and classification of electrocardiograms was performed by a trained nurse. Results. A total of 45 patients were enrolled and had a mean follow-up of 181.5 days (±91.48). We received 7162 records: 96.31% were routine daily electrocardiograms and only 0.43% were not interpretable. The median adherence was 92.95% (IQR 26.44), being significantly superior in women (96.74% vs 82.22; p=0.038), with a superiority trend in paroxysmal vs. persistent atrial fibrillation (94.87% vs 79.53%; p=0.069) and in patients >62 years of age (94.89% vs 78.43%; p=0.068). A total of 330 atrial fibrillation records were detected (4.6%) in 14 patients (31.1%). Atrial fibrillation was recorded significantly more frequently in extra electrocardiograms compared to daily electrocardiograms (9.46% vs 4.44% p=0.0005), with a 2.24 fold risk increase of having atrial fibrillation in extra electrocardiograms. Conclusions. Obtaining records with an electrocardiogram portable device is feasible and improves the identification of atrial fibrillation recurrences by a nurse team, with an extraordinary adherence of patients. The use of these type of devices allows the patient to obtain an electrocardiogram recording during symptoms, which improves diagnostic performance. Introducción y objetivo. Tras la ablación de fibrilación auricular es fundamental detectar las recurrencias, que suelen pasar inadvertidas. El objetivo del estudio es conocer la capacidad de detección de recurrencias de fibrilación auricular mediante un dispositivo portátil de electrocardiogramas y la adherencia de los pacientes, con un seguimiento realizado por enfermería. Material y métodos. Se ha realizado un estudio prospectivo observacional sobre los pacientes del estudio CAVAC-AF a quienes se les proporcionó un dispositivo de registro electrocardiográfico portátil. A los pacientes se les instruyó para realizar un electrocardiograma di