Symptom severity assessment in patients with atrial fibrillation after catheter ablation using a smartphone application

Aims Symptom severity in atrial fibrillation (AF) influences healthcare use, but conventional assessments lack temporal precision. We evaluated the feasibility of smartphone-based symptom severity assessment after AF catheter ablation and explored predictors and variability of symptom severity.Methods and results In this analysis of the ISOLATION study, 140 patients used a photoplethysmography-supported smartphone application to record heart rhythm, symptoms, and symptom severity three times daily and when symptomatic for 7 days at 3, 6, and 12 months after ablation. Symptom severity was classified using the modified European Heart Rhythm Association scale. A total of 8575 recordings were analysed, of which 11% showed AF. Median adherence was 67%. Symptom severity was higher during AF, in women, and with higher heart rate. Nearly half of AF recordings were asymptomatic.Conclusion Smartphone-based symptom severity assessment after AF ablation is feasible and reveals substantial individual variability beyond rhythm status alone.