Long-term ECG monitoring using an implantable loop recorder for the detection of atrial fibrillation after cavotricuspid isthmus ablation in patients with atrial flutter
<p><strong>Objective.</strong> In patients with atrial flutter who undergo cavotricuspid isthmus ablation, long-term electrocardiographic (ECG) monitoring may identify a new onset of atrial fibrillation (AF). The purpose of our study was to ascertain, through the use of an implanta...
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| Format: | Article |
| Language: | English |
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Meshalkin National Medical Research Center
2015-10-01
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| Series: | Патология кровообращения и кардиохирургия |
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| Online Access: | http://journalmeshalkin.ru/index.php/heartjournal/article/view/249 |
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| author | С. А. Байрамова А. Б. Романов С. Миттель Д. Муссат Д. Стейнберг Е. А. Покушалов |
| author_facet | С. А. Байрамова А. Б. Романов С. Миттель Д. Муссат Д. Стейнберг Е. А. Покушалов |
| author_sort | С. А. Байрамова |
| collection | DOAJ |
| description | <p><strong>Objective.</strong> In patients with atrial flutter who undergo cavotricuspid isthmus ablation, long-term electrocardiographic (ECG) monitoring may identify a new onset of atrial fibrillation (AF). The purpose of our study was to ascertain, through the use of an implantable loop recorder (ILR) with a dedicated AF detection algorithm, the incidence, duration, and burden of new AF in these patients and to develop an optimal post-ablation ECG monitoring strategy.<br /><strong>Methods.</strong> We enrolled 20 patients with flutter, a CHADS2 score of 2–3, and no prior episode of AF. After cavotricuspid isthmus ablation, we implanted an ILR, which was interrogated routinely in order to evaluate and analyze all stored ECG data.<br /><strong>Results.</strong> During a mean follow-up of 382±218 days, 3 patterns were observed. First, in 11 (55%) patients stored ECGs confirmed AF at 62±38 days after ablation. Second, in 4 (20%) patients, although the ILR suggested AF, the episodes actually represented sinus rhythm with frequent premature atrial contractions and/or over-sensing. Third, in 5 (25%) patients, no AF was observed. The episodes less than 4 hours were associated with low AF burden (<1%) or false detections. The 1-year freedom from any episode of AF less than 4 and 12 hours was 52% and 83%, respectively.<br /><strong>Conclusion</strong>. Our data show that many (but not all) patients develop new AF within the first 4 months of flutter ablation. Since external ECG monitoring for this duration is impractical, the ILR has an important role for long-term AF surveillance. Future research should be directed toward identifying the relationship between the duration/burden of AF and stroke and improving the existing ILR technology.</p> |
| first_indexed | 2024-03-12T08:40:45Z |
| format | Article |
| id | doaj.art-6a268bbd03d64dbf81cadb468675387c |
| institution | Directory Open Access Journal |
| issn | 1681-3472 2500-3119 |
| language | English |
| last_indexed | 2024-03-12T08:40:45Z |
| publishDate | 2015-10-01 |
| publisher | Meshalkin National Medical Research Center |
| record_format | Article |
| series | Патология кровообращения и кардиохирургия |
| spelling | doaj.art-6a268bbd03d64dbf81cadb468675387c2023-09-02T16:49:02ZengMeshalkin National Medical Research CenterПатология кровообращения и кардиохирургия1681-34722500-31192015-10-0119310010910.21688/1681-3472-2015-3-100-109965Long-term ECG monitoring using an implantable loop recorder for the detection of atrial fibrillation after cavotricuspid isthmus ablation in patients with atrial flutterС. А. Байрамова0А. Б. Романов1С. Миттель2Д. Муссат3Д. Стейнберг4Е. А. Покушалов5ФГБУ «Новосибирский научно-исследовательский институт имени академика Е.Н. Мешалкина» Минздрава России, 630055, Россия, Новосибирск, ул. Речкуновская,15ФГБУ «Новосибирский научно-исследовательский институт имени академика Е.Н. Мешалкина» Минздрава России, 630055, Россия, Новосибирск, ул. Речкуновская,15Arrhythmia Institute, Valley Health System, The Valley Hospital, Ridgewood, New Jersey, USA; Columbia University College of Physicians and Surgeons, New York, New York, USAArrhythmia Institute, Valley Health System, The Valley Hospital, Ridgewood, New Jersey, USA; Columbia University College of Physicians and Surgeons, New York, New York, USAArrhythmia Institute, Valley Health System, The Valley Hospital, Ridgewood, New Jersey, USA; Columbia University College of Physicians and Surgeons, New York, New York, USAФГБУ «Новосибирский научно-исследовательский институт имени академика Е.Н. Мешалкина» Минздрава России, 630055, Россия, Новосибирск, ул. Речкуновская,15<p><strong>Objective.</strong> In patients with atrial flutter who undergo cavotricuspid isthmus ablation, long-term electrocardiographic (ECG) monitoring may identify a new onset of atrial fibrillation (AF). The purpose of our study was to ascertain, through the use of an implantable loop recorder (ILR) with a dedicated AF detection algorithm, the incidence, duration, and burden of new AF in these patients and to develop an optimal post-ablation ECG monitoring strategy.<br /><strong>Methods.</strong> We enrolled 20 patients with flutter, a CHADS2 score of 2–3, and no prior episode of AF. After cavotricuspid isthmus ablation, we implanted an ILR, which was interrogated routinely in order to evaluate and analyze all stored ECG data.<br /><strong>Results.</strong> During a mean follow-up of 382±218 days, 3 patterns were observed. First, in 11 (55%) patients stored ECGs confirmed AF at 62±38 days after ablation. Second, in 4 (20%) patients, although the ILR suggested AF, the episodes actually represented sinus rhythm with frequent premature atrial contractions and/or over-sensing. Third, in 5 (25%) patients, no AF was observed. The episodes less than 4 hours were associated with low AF burden (<1%) or false detections. The 1-year freedom from any episode of AF less than 4 and 12 hours was 52% and 83%, respectively.<br /><strong>Conclusion</strong>. Our data show that many (but not all) patients develop new AF within the first 4 months of flutter ablation. Since external ECG monitoring for this duration is impractical, the ILR has an important role for long-term AF surveillance. Future research should be directed toward identifying the relationship between the duration/burden of AF and stroke and improving the existing ILR technology.</p>http://journalmeshalkin.ru/index.php/heartjournal/article/view/249Фибрилляция предсердийТрепетание предсердийКатетерная аблацияКавотрикуспидальный перешеекИмплантируемый петлевой регистратор |
| spellingShingle | С. А. Байрамова А. Б. Романов С. Миттель Д. Муссат Д. Стейнберг Е. А. Покушалов Long-term ECG monitoring using an implantable loop recorder for the detection of atrial fibrillation after cavotricuspid isthmus ablation in patients with atrial flutter Патология кровообращения и кардиохирургия Фибрилляция предсердий Трепетание предсердий Катетерная аблация Кавотрикуспидальный перешеек Имплантируемый петлевой регистратор |
| title | Long-term ECG monitoring using an implantable loop recorder for the detection of atrial fibrillation after cavotricuspid isthmus ablation in patients with atrial flutter |
| title_full | Long-term ECG monitoring using an implantable loop recorder for the detection of atrial fibrillation after cavotricuspid isthmus ablation in patients with atrial flutter |
| title_fullStr | Long-term ECG monitoring using an implantable loop recorder for the detection of atrial fibrillation after cavotricuspid isthmus ablation in patients with atrial flutter |
| title_full_unstemmed | Long-term ECG monitoring using an implantable loop recorder for the detection of atrial fibrillation after cavotricuspid isthmus ablation in patients with atrial flutter |
| title_short | Long-term ECG monitoring using an implantable loop recorder for the detection of atrial fibrillation after cavotricuspid isthmus ablation in patients with atrial flutter |
| title_sort | long term ecg monitoring using an implantable loop recorder for the detection of atrial fibrillation after cavotricuspid isthmus ablation in patients with atrial flutter |
| topic | Фибрилляция предсердий Трепетание предсердий Катетерная аблация Кавотрикуспидальный перешеек Имплантируемый петлевой регистратор |
| url | http://journalmeshalkin.ru/index.php/heartjournal/article/view/249 |
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