Continuous monitoring after atrial fibrillation ablation: the LINQ AF study
To study device performance, arrhythmia recurrence characteristics, and methods of outcome assessment using a novel implantable cardiac monitor (ICM) in patients undergoing ablation for atrial fibrillation (AF). In 419 consecutive patients undergoing first-time catheter ablation for symptomatic paro...
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| Veröffentlicht in: | Europace (London, England) England), 2018-11, Vol.20 (FI_3), p.f312-f320 |
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| creator | Wechselberger, Simon Kronborg, Mads Huo, Yan Piorkowski, Judith Neudeck, Sebastian Päßler, Ellen El-Armouche, Ali Richter, Utz Mayer, Julia Ulbrich, Stefan Pu, Liying Kirstein, Bettina Gaspar, Thomas Piorkowski, Christopher |
| description | To study device performance, arrhythmia recurrence characteristics, and methods of outcome assessment using a novel implantable cardiac monitor (ICM) in patients undergoing ablation for atrial fibrillation (AF).
In 419 consecutive patients undergoing first-time catheter ablation for symptomatic paroxysmal (n = 224) or persistent (n = 195) AF an ICM was injected at the end of the procedure. Telemedicine staff ensured full episode transmission coverage and manually evaluated all automatic arrhythmia episodes. Device detection metrics were calculated for ≥2, ≥6, and ≥10 min AF detection durations. Four methods of outcome assessment were studied: continuous recurrence analysis, discontinuous recurrence analysis, AF-burden analysis, and analysis of individual rhythm profiles. A total of 43 673 automatic AF episodes were transmitted over a follow-up of 15 ± 6 months. Episode-based positive predictive values changed significantly with longer AF detection durations (70.5% for ≥2 min, 81.8% for ≥6 min, and 85.9% for ≥10 min). Patients with exclusive short episode recurrences (≥2 to 6 min and AF burden >0.1% as a standardized outcome definition for AF studies to come in the future. |
| doi_str_mv | 10.1093/europace/euy038 |
| format | Article |
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In 419 consecutive patients undergoing first-time catheter ablation for symptomatic paroxysmal (n = 224) or persistent (n = 195) AF an ICM was injected at the end of the procedure. Telemedicine staff ensured full episode transmission coverage and manually evaluated all automatic arrhythmia episodes. Device detection metrics were calculated for ≥2, ≥6, and ≥10 min AF detection durations. Four methods of outcome assessment were studied: continuous recurrence analysis, discontinuous recurrence analysis, AF-burden analysis, and analysis of individual rhythm profiles. A total of 43 673 automatic AF episodes were transmitted over a follow-up of 15 ± 6 months. Episode-based positive predictive values changed significantly with longer AF detection durations (70.5% for ≥2 min, 81.8% for ≥6 min, and 85.9% for ≥10 min). Patients with exclusive short episode recurrences (≥2 to <6 min) were rare and their arrhythmia detection was clinically irrelevant. Different methods of outcome assessment showed a large variation (46-79%) in ablation success. Individual rhythm characteristics and subclinical AF added to this inconsistency. Analysis of AF-burden and individual rhythm profiles were least influenced and showed successful treatment in 60-70% of the patients.
We suggest AF detection duration >6 min and AF burden >0.1% as a standardized outcome definition for AF studies to come in the future.</description><identifier>ISSN: 1099-5129</identifier><identifier>EISSN: 1532-2092</identifier><identifier>DOI: 10.1093/europace/euy038</identifier><identifier>PMID: 29688326</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Aged ; Anti-Arrhythmia Agents - therapeutic use ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - physiopathology ; Atrial Fibrillation - surgery ; Catheter Ablation - adverse effects ; Clinical Research ; Diagnostic Equipment ; Electrocardiography, Ambulatory - instrumentation ; Electrocardiography, Ambulatory - methods ; Equipment Design ; Female ; Heart Rate - drug effects ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Recurrence ; Telemedicine - instrumentation ; Telemedicine - methods ; Telemetry - instrumentation ; Telemetry - methods ; Time Factors ; Treatment Outcome</subject><ispartof>Europace (London, England), 2018-11, Vol.20 (FI_3), p.f312-f320</ispartof><rights>The Author(s) 2018. Published by Oxford University Press on behalf of the European Society of Cardiology. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-58852f02d14d50a1699d963a0682d0e037568ab09f93e410a1bb26b6ad6c51bd3</citedby><cites>FETCH-LOGICAL-c393t-58852f02d14d50a1699d963a0682d0e037568ab09f93e410a1bb26b6ad6c51bd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277150/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277150/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29688326$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wechselberger, Simon</creatorcontrib><creatorcontrib>Kronborg, Mads</creatorcontrib><creatorcontrib>Huo, Yan</creatorcontrib><creatorcontrib>Piorkowski, Judith</creatorcontrib><creatorcontrib>Neudeck, Sebastian</creatorcontrib><creatorcontrib>Päßler, Ellen</creatorcontrib><creatorcontrib>El-Armouche, Ali</creatorcontrib><creatorcontrib>Richter, Utz</creatorcontrib><creatorcontrib>Mayer, Julia</creatorcontrib><creatorcontrib>Ulbrich, Stefan</creatorcontrib><creatorcontrib>Pu, Liying</creatorcontrib><creatorcontrib>Kirstein, Bettina</creatorcontrib><creatorcontrib>Gaspar, Thomas</creatorcontrib><creatorcontrib>Piorkowski, Christopher</creatorcontrib><title>Continuous monitoring after atrial fibrillation ablation: the LINQ AF study</title><title>Europace (London, England)</title><addtitle>Europace</addtitle><description>To study device performance, arrhythmia recurrence characteristics, and methods of outcome assessment using a novel implantable cardiac monitor (ICM) in patients undergoing ablation for atrial fibrillation (AF).
In 419 consecutive patients undergoing first-time catheter ablation for symptomatic paroxysmal (n = 224) or persistent (n = 195) AF an ICM was injected at the end of the procedure. Telemedicine staff ensured full episode transmission coverage and manually evaluated all automatic arrhythmia episodes. Device detection metrics were calculated for ≥2, ≥6, and ≥10 min AF detection durations. Four methods of outcome assessment were studied: continuous recurrence analysis, discontinuous recurrence analysis, AF-burden analysis, and analysis of individual rhythm profiles. A total of 43 673 automatic AF episodes were transmitted over a follow-up of 15 ± 6 months. Episode-based positive predictive values changed significantly with longer AF detection durations (70.5% for ≥2 min, 81.8% for ≥6 min, and 85.9% for ≥10 min). Patients with exclusive short episode recurrences (≥2 to <6 min) were rare and their arrhythmia detection was clinically irrelevant. Different methods of outcome assessment showed a large variation (46-79%) in ablation success. Individual rhythm characteristics and subclinical AF added to this inconsistency. Analysis of AF-burden and individual rhythm profiles were least influenced and showed successful treatment in 60-70% of the patients.
We suggest AF detection duration >6 min and AF burden >0.1% as a standardized outcome definition for AF studies to come in the future.</description><subject>Aged</subject><subject>Anti-Arrhythmia Agents - therapeutic use</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>Atrial Fibrillation - surgery</subject><subject>Catheter Ablation - adverse effects</subject><subject>Clinical Research</subject><subject>Diagnostic Equipment</subject><subject>Electrocardiography, Ambulatory - instrumentation</subject><subject>Electrocardiography, Ambulatory - methods</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Heart Rate - drug effects</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Recurrence</subject><subject>Telemedicine - instrumentation</subject><subject>Telemedicine - methods</subject><subject>Telemetry - instrumentation</subject><subject>Telemetry - methods</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1099-5129</issn><issn>1532-2092</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUU1LAzEQDaLYWj17kxy9rJ0kTbrxIJRitVgUQc8hu5ttI9tNTbJC_72R1qIwMA_mzZuPh9AlgRsCkg1N591GlyaBLbD8CPUJZzSjIOlxwiBlxgmVPXQWwgcAjKnkp6hHpchzRkUfPU1dG23buS7gtWttdN62S6zraDzW0Vvd4NoW3jaNjta1WBc7cIvjyuDF_PkVT2Y4xK7anqOTWjfBXOzzAL3P7t-mj9ni5WE-nSyykkkWM57nnNZAKzKqOGgipKykYBpETiswwMZc5LoAWUtmRiQxioKKQuhKlJwUFRugu53upivWpipNG71u1MbbtfZb5bRV_yutXaml-1KCjseEQxK43gt499mZENXahtKkE1uTHqEoMJKC5zxRhztq6V0I3tSHMQTUjwXq1wK1syB1XP3d7sD__Tn7BqhVhiQ</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Wechselberger, Simon</creator><creator>Kronborg, Mads</creator><creator>Huo, Yan</creator><creator>Piorkowski, Judith</creator><creator>Neudeck, Sebastian</creator><creator>Päßler, Ellen</creator><creator>El-Armouche, Ali</creator><creator>Richter, Utz</creator><creator>Mayer, Julia</creator><creator>Ulbrich, Stefan</creator><creator>Pu, Liying</creator><creator>Kirstein, Bettina</creator><creator>Gaspar, Thomas</creator><creator>Piorkowski, Christopher</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20181101</creationdate><title>Continuous monitoring after atrial fibrillation ablation: the LINQ AF study</title><author>Wechselberger, Simon ; Kronborg, Mads ; Huo, Yan ; Piorkowski, Judith ; Neudeck, Sebastian ; Päßler, Ellen ; El-Armouche, Ali ; Richter, Utz ; Mayer, Julia ; Ulbrich, Stefan ; Pu, Liying ; Kirstein, Bettina ; Gaspar, Thomas ; Piorkowski, Christopher</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-58852f02d14d50a1699d963a0682d0e037568ab09f93e410a1bb26b6ad6c51bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Anti-Arrhythmia Agents - therapeutic use</topic><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>Atrial Fibrillation - surgery</topic><topic>Catheter Ablation - adverse effects</topic><topic>Clinical Research</topic><topic>Diagnostic Equipment</topic><topic>Electrocardiography, Ambulatory - instrumentation</topic><topic>Electrocardiography, Ambulatory - methods</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Heart Rate - drug effects</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Telemedicine - instrumentation</topic><topic>Telemedicine - methods</topic><topic>Telemetry - instrumentation</topic><topic>Telemetry - methods</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wechselberger, Simon</creatorcontrib><creatorcontrib>Kronborg, Mads</creatorcontrib><creatorcontrib>Huo, Yan</creatorcontrib><creatorcontrib>Piorkowski, Judith</creatorcontrib><creatorcontrib>Neudeck, Sebastian</creatorcontrib><creatorcontrib>Päßler, Ellen</creatorcontrib><creatorcontrib>El-Armouche, Ali</creatorcontrib><creatorcontrib>Richter, Utz</creatorcontrib><creatorcontrib>Mayer, Julia</creatorcontrib><creatorcontrib>Ulbrich, Stefan</creatorcontrib><creatorcontrib>Pu, Liying</creatorcontrib><creatorcontrib>Kirstein, Bettina</creatorcontrib><creatorcontrib>Gaspar, Thomas</creatorcontrib><creatorcontrib>Piorkowski, Christopher</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Europace (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wechselberger, Simon</au><au>Kronborg, Mads</au><au>Huo, Yan</au><au>Piorkowski, Judith</au><au>Neudeck, Sebastian</au><au>Päßler, Ellen</au><au>El-Armouche, Ali</au><au>Richter, Utz</au><au>Mayer, Julia</au><au>Ulbrich, Stefan</au><au>Pu, Liying</au><au>Kirstein, Bettina</au><au>Gaspar, Thomas</au><au>Piorkowski, Christopher</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Continuous monitoring after atrial fibrillation ablation: the LINQ AF study</atitle><jtitle>Europace (London, England)</jtitle><addtitle>Europace</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>20</volume><issue>FI_3</issue><spage>f312</spage><epage>f320</epage><pages>f312-f320</pages><issn>1099-5129</issn><eissn>1532-2092</eissn><abstract>To study device performance, arrhythmia recurrence characteristics, and methods of outcome assessment using a novel implantable cardiac monitor (ICM) in patients undergoing ablation for atrial fibrillation (AF).
In 419 consecutive patients undergoing first-time catheter ablation for symptomatic paroxysmal (n = 224) or persistent (n = 195) AF an ICM was injected at the end of the procedure. Telemedicine staff ensured full episode transmission coverage and manually evaluated all automatic arrhythmia episodes. Device detection metrics were calculated for ≥2, ≥6, and ≥10 min AF detection durations. Four methods of outcome assessment were studied: continuous recurrence analysis, discontinuous recurrence analysis, AF-burden analysis, and analysis of individual rhythm profiles. A total of 43 673 automatic AF episodes were transmitted over a follow-up of 15 ± 6 months. Episode-based positive predictive values changed significantly with longer AF detection durations (70.5% for ≥2 min, 81.8% for ≥6 min, and 85.9% for ≥10 min). Patients with exclusive short episode recurrences (≥2 to <6 min) were rare and their arrhythmia detection was clinically irrelevant. Different methods of outcome assessment showed a large variation (46-79%) in ablation success. Individual rhythm characteristics and subclinical AF added to this inconsistency. Analysis of AF-burden and individual rhythm profiles were least influenced and showed successful treatment in 60-70% of the patients.
We suggest AF detection duration >6 min and AF burden >0.1% as a standardized outcome definition for AF studies to come in the future.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>29688326</pmid><doi>10.1093/europace/euy038</doi><oa>free_for_read</oa></addata></record> |
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| source | Oxford Journals Open Access Collection; MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Aged Anti-Arrhythmia Agents - therapeutic use Atrial Fibrillation - diagnosis Atrial Fibrillation - physiopathology Atrial Fibrillation - surgery Catheter Ablation - adverse effects Clinical Research Diagnostic Equipment Electrocardiography, Ambulatory - instrumentation Electrocardiography, Ambulatory - methods Equipment Design Female Heart Rate - drug effects Humans Male Middle Aged Predictive Value of Tests Prospective Studies Recurrence Telemedicine - instrumentation Telemedicine - methods Telemetry - instrumentation Telemetry - methods Time Factors Treatment Outcome |
| title | Continuous monitoring after atrial fibrillation ablation: the LINQ AF study |
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