Long-term intermittent versus short continuous heart rhythm monitoring for the detection of atrial fibrillation recurrences after catheter ablation

Astrid N. L. Hermans; Monika Gawalko; Nikki A. H. A. Pluymaekers; Trang Dinh; Bob Weijs; Manouk J. W. van Mourik; Bianca Vorstermans; Dennis W. den Uijl; Ludo Opsteyn; Hilco Snippe; Kevin Vernooy; Harry J. G. M. Crijns; Dominik Linz; Justin G. L. M. Luermans

doi:10.1016/j.ijcard.2020.12.077

Long-term intermittent versus short continuous heart rhythm monitoring for the detection of atrial fibrillation recurrences after catheter ablation

Astrid N. L. Hermans, Monika Gawalko, Nikki A. H. A. Pluymaekers, Trang Dinh, Bob Weijs, Manouk J. W. van Mourik, Bianca Vorstermans, Dennis W. den Uijl, Ludo Opsteyn, Hilco Snippe, Kevin Vernooy, Harry J. G. M. Crijns, Dominik Linz, Justin G. L. M. Luermans^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: The utility of long-term intermittent heart rhythm monitoring after atrial fibrillation (AF) ablation remains undear. Therefore, we compared the efficacy and usability of long-term intermittent (AliveCor Kardia (R) (ACK)) versus short continuous (Hotter) heart rhythm monitoring for the detection of AF recurrences after AF ablation and evaluated ACK accuracy to detect AF.

Methods: Patients were provided with Hotter (for >= 24 h) simultaneously with an ACK (4 weeks) used three times a day and in case of symptoms. The primary endpoint was the difference in proportion of patients diagnosed with recurrent AF by ACK as compared to Holier monitoring. Secondary endpoints were the usability (System Usability Scale and a four-item questionnaire) of ACK and Holler monitoring; and the accuracy of the ACK algorithm for AF detection.

Results: Out of 126 post-ablation patients, 115 (91.3%; 35 females, median age 64.0 [58.0-68.0] years) transmitted overall 7838 ACK ECG recordings. ACK and Holler monitoring detected 29 (252%) and 17 (14.8%) patients with AF recurrences, respectively (p < 0.001). More than 2 weeks of ACK monitoring did not have additional diagnostic yield for detection of AF recurrences. Patients graded ACK higher than Hotter monitoring and found ACK more convenient in daily usage than Holler (p < 0.001). Sensitivity and specificity of ACK for AF detection were 95.3% and 97.5%, respectively.

Conclusions: Long-term intermittent monitoring by ACK more effectively detects AF recurrences after AF ablation and has a higher patients' usability than short continuous Holter monitoring. ACK showed a high accuracy to detect AF. (C) 2021 Elsevier B.V. All rights reserved.

Original language	English
Pages (from-to)	105-112
Number of pages	8
Journal	International Journal of Cardiology
Volume	329
DOIs	https://doi.org/10.1016/j.ijcard.2020.12.077
Publication status	Published - 15 Apr 2021

Keywords

AliveCor
Atrial fibrillation
Holter
Telemonitoring
e-health
m-health
MANAGEMENT
EXPERT CONSENSUS STATEMENT
FOLLOW-UP
SURGICAL ABLATION

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10.1016/j.ijcard.2020.12.077

Cite this

Hermans, A. N. L., Gawalko, M., Pluymaekers, N. A. H. A., Dinh, T., Weijs, B., van Mourik, M. J. W., Vorstermans, B., den Uijl, D. W., Opsteyn, L., Snippe, H., Vernooy, K., Crijns, H. J. G. M., Linz, D., & Luermans, J. G. L. M. (2021). Long-term intermittent versus short continuous heart rhythm monitoring for the detection of atrial fibrillation recurrences after catheter ablation. International Journal of Cardiology, 329, 105-112. https://doi.org/10.1016/j.ijcard.2020.12.077

@article{3e7e2871bafe49348914122275cbc918,

title = "Long-term intermittent versus short continuous heart rhythm monitoring for the detection of atrial fibrillation recurrences after catheter ablation",

abstract = "Background: The utility of long-term intermittent heart rhythm monitoring after atrial fibrillation (AF) ablation remains undear. Therefore, we compared the efficacy and usability of long-term intermittent (AliveCor Kardia (R) (ACK)) versus short continuous (Hotter) heart rhythm monitoring for the detection of AF recurrences after AF ablation and evaluated ACK accuracy to detect AF.Methods: Patients were provided with Hotter (for >= 24 h) simultaneously with an ACK (4 weeks) used three times a day and in case of symptoms. The primary endpoint was the difference in proportion of patients diagnosed with recurrent AF by ACK as compared to Holier monitoring. Secondary endpoints were the usability (System Usability Scale and a four-item questionnaire) of ACK and Holler monitoring; and the accuracy of the ACK algorithm for AF detection.Results: Out of 126 post-ablation patients, 115 (91.3%; 35 females, median age 64.0 [58.0-68.0] years) transmitted overall 7838 ACK ECG recordings. ACK and Holler monitoring detected 29 (252%) and 17 (14.8%) patients with AF recurrences, respectively (p < 0.001). More than 2 weeks of ACK monitoring did not have additional diagnostic yield for detection of AF recurrences. Patients graded ACK higher than Hotter monitoring and found ACK more convenient in daily usage than Holler (p < 0.001). Sensitivity and specificity of ACK for AF detection were 95.3% and 97.5%, respectively.Conclusions: Long-term intermittent monitoring by ACK more effectively detects AF recurrences after AF ablation and has a higher patients' usability than short continuous Holter monitoring. ACK showed a high accuracy to detect AF. (C) 2021 Elsevier B.V. All rights reserved.",

keywords = "AliveCor, Atrial fibrillation, Holter, Telemonitoring, e-health, m-health, MANAGEMENT, EXPERT CONSENSUS STATEMENT, FOLLOW-UP, SURGICAL ABLATION",

author = "Hermans, {Astrid N. L.} and Monika Gawalko and Pluymaekers, {Nikki A. H. A.} and Trang Dinh and Bob Weijs and {van Mourik}, {Manouk J. W.} and Bianca Vorstermans and {den Uijl}, {Dennis W.} and Ludo Opsteyn and Hilco Snippe and Kevin Vernooy and Crijns, {Harry J. G. M.} and Dominik Linz and Luermans, {Justin G. L. M.}",

note = "Funding Information: This work was supported by Health Foundation Limburg and the RESCAR . Publisher Copyright: {\textcopyright} 2021 Elsevier B.V.",

year = "2021",

month = apr,

day = "15",

doi = "10.1016/j.ijcard.2020.12.077",

language = "English",

volume = "329",

pages = "105--112",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier Ireland Ltd",

}

Hermans, ANL, Gawalko, M, Pluymaekers, NAHA , Dinh, T, Weijs, B, van Mourik, MJW, Vorstermans, B, den Uijl, DW, Opsteyn, L, Snippe, H, Vernooy, K , Crijns, HJGM , Linz, D & Luermans, JGLM 2021, 'Long-term intermittent versus short continuous heart rhythm monitoring for the detection of atrial fibrillation recurrences after catheter ablation', International Journal of Cardiology, vol. 329, pp. 105-112. https://doi.org/10.1016/j.ijcard.2020.12.077

Long-term intermittent versus short continuous heart rhythm monitoring for the detection of atrial fibrillation recurrences after catheter ablation. / Hermans, Astrid N. L.; Gawalko, Monika; Pluymaekers, Nikki A. H. A. et al.
In: International Journal of Cardiology, Vol. 329, 15.04.2021, p. 105-112.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Long-term intermittent versus short continuous heart rhythm monitoring for the detection of atrial fibrillation recurrences after catheter ablation

AU - Hermans, Astrid N. L.

AU - Gawalko, Monika

AU - Pluymaekers, Nikki A. H. A.

AU - Dinh, Trang

AU - Weijs, Bob

AU - van Mourik, Manouk J. W.

AU - Vorstermans, Bianca

AU - den Uijl, Dennis W.

AU - Opsteyn, Ludo

AU - Snippe, Hilco

AU - Vernooy, Kevin

AU - Crijns, Harry J. G. M.

AU - Linz, Dominik

AU - Luermans, Justin G. L. M.

PY - 2021/4/15

Y1 - 2021/4/15

N2 - Background: The utility of long-term intermittent heart rhythm monitoring after atrial fibrillation (AF) ablation remains undear. Therefore, we compared the efficacy and usability of long-term intermittent (AliveCor Kardia (R) (ACK)) versus short continuous (Hotter) heart rhythm monitoring for the detection of AF recurrences after AF ablation and evaluated ACK accuracy to detect AF.Methods: Patients were provided with Hotter (for >= 24 h) simultaneously with an ACK (4 weeks) used three times a day and in case of symptoms. The primary endpoint was the difference in proportion of patients diagnosed with recurrent AF by ACK as compared to Holier monitoring. Secondary endpoints were the usability (System Usability Scale and a four-item questionnaire) of ACK and Holler monitoring; and the accuracy of the ACK algorithm for AF detection.Results: Out of 126 post-ablation patients, 115 (91.3%; 35 females, median age 64.0 [58.0-68.0] years) transmitted overall 7838 ACK ECG recordings. ACK and Holler monitoring detected 29 (252%) and 17 (14.8%) patients with AF recurrences, respectively (p < 0.001). More than 2 weeks of ACK monitoring did not have additional diagnostic yield for detection of AF recurrences. Patients graded ACK higher than Hotter monitoring and found ACK more convenient in daily usage than Holler (p < 0.001). Sensitivity and specificity of ACK for AF detection were 95.3% and 97.5%, respectively.Conclusions: Long-term intermittent monitoring by ACK more effectively detects AF recurrences after AF ablation and has a higher patients' usability than short continuous Holter monitoring. ACK showed a high accuracy to detect AF. (C) 2021 Elsevier B.V. All rights reserved.

AB - Background: The utility of long-term intermittent heart rhythm monitoring after atrial fibrillation (AF) ablation remains undear. Therefore, we compared the efficacy and usability of long-term intermittent (AliveCor Kardia (R) (ACK)) versus short continuous (Hotter) heart rhythm monitoring for the detection of AF recurrences after AF ablation and evaluated ACK accuracy to detect AF.Methods: Patients were provided with Hotter (for >= 24 h) simultaneously with an ACK (4 weeks) used three times a day and in case of symptoms. The primary endpoint was the difference in proportion of patients diagnosed with recurrent AF by ACK as compared to Holier monitoring. Secondary endpoints were the usability (System Usability Scale and a four-item questionnaire) of ACK and Holler monitoring; and the accuracy of the ACK algorithm for AF detection.Results: Out of 126 post-ablation patients, 115 (91.3%; 35 females, median age 64.0 [58.0-68.0] years) transmitted overall 7838 ACK ECG recordings. ACK and Holler monitoring detected 29 (252%) and 17 (14.8%) patients with AF recurrences, respectively (p < 0.001). More than 2 weeks of ACK monitoring did not have additional diagnostic yield for detection of AF recurrences. Patients graded ACK higher than Hotter monitoring and found ACK more convenient in daily usage than Holler (p < 0.001). Sensitivity and specificity of ACK for AF detection were 95.3% and 97.5%, respectively.Conclusions: Long-term intermittent monitoring by ACK more effectively detects AF recurrences after AF ablation and has a higher patients' usability than short continuous Holter monitoring. ACK showed a high accuracy to detect AF. (C) 2021 Elsevier B.V. All rights reserved.

KW - AliveCor

KW - Atrial fibrillation

KW - Holter

KW - Telemonitoring

KW - e-health

KW - m-health

KW - MANAGEMENT

KW - EXPERT CONSENSUS STATEMENT

KW - FOLLOW-UP

KW - SURGICAL ABLATION

U2 - 10.1016/j.ijcard.2020.12.077

DO - 10.1016/j.ijcard.2020.12.077

M3 - Article

C2 - 33412184

SN - 0167-5273

VL - 329

SP - 105

EP - 112

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -