Absence of Correlation Between Symptoms and Rhythm in “Symptomatic” Atrial Fibrillation

Mehall, John R.; Kohut, Robert M.; Schneeberger, Eric W.; Merrill, Walter H.; Wolf, Randall K.

doi:10.1016/j.athoracsur.2007.02.084

Cited by 40 publications

(21 citation statements)

References 9 publications

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“…Because symptoms alone are not adequate for determining effectiveness of therapy,22 pulse taking is an important strategy for monitoring response to treatment whether the goal is rate control or maintenance of sinus rhythm. Patients should be taught how to palpate their pulse, count its rate, and monitor the pattern for irregularity 13.…”

Section: Education and Counseling Componentsmentioning

confidence: 99%

What patients want and need to know about atrial fibrillation

McCabe¹

2011

JMDH

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Clinicians in a variety of settings are called upon to care for patients diagnosed with atrial fibrillation (AF), a common chronic condition that affects up to 3 million people in the USA. Evidence-based guidelines provide clinicians with direction for treatment of AF, but recommended content for educating patients and counseling about self-management of AF is not included in published guidelines. When patients believe they have a good understanding of AF they report fewer symptoms, perceive greater control over AF, and attribute less emotional distress to AF. Thus, providing patients with information about AF and how to manage it is important for promoting positive outcomes. The purpose of this article is to offer evidence-based recommendations for content to include in self-management education and counseling for patients with AF. Approaches for educating and counseling patients related to AF pathophysiology, the nature of AF (its cause, consequences, and trajectory), treatments, action plans, and symptom management, and managing the psychosocial challenges of living with AF, are discussed.

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Section: Education and Counseling Componentsmentioning

confidence: 99%

What patients want and need to know about atrial fibrillation

McCabe¹

2011

JMDH

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“…Nevertheless, it is well known that patients with symptomatic AF may also have asymptomatic episodes [5], which can increase after ablation [6,7], and there is a poor correlation between symptoms and the underlying heart rhythm [8,9]. Therefore, it is quite risky to rely on patient-reported symptoms, as it can lead to misclassification of patients with/ without real recurrences of the arrhythmia.…”

Section: Introductionmentioning

confidence: 97%

Ablation of paroxysmal atrial fibrillation during coronary artery bypass grafting: 12 months’ follow-up through implantable loop recorder

Pokushalov

Romanov

Cherniavsky

et al. 2011

European Journal of Cardio-Thoracic Surgery

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“…3 Numerous studies, however, have demonstrated that a majority of AF episodes are asymptomatic and even in patients with symptomatic atrial fibrillation a lack of correlation between symptoms and actual heart rhythm was reported. 4 Furthermore, asymptomatic AF episodes even increase after atrial fibrillation ablation treatment. [5][6][7] …”

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confidence: 99%

Twenty-Four–Hour Holter Monitor Follow-Up Does Not Provide Accurate Heart Rhythm Status After Surgical Atrial Fibrillation Ablation Therapy

et al. 2009

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Background-Twenty-four-hour Holter monitoring (24HM) is commonly used to assess cardiac rhythm after surgical therapy of atrial fibrillation (AF). However, this "snapshot" documentation leaves a considerable diagnostic window and only stores short-time cardiac rhythm episodes. To improve accuracy of rhythm surveillance after surgical ablation therapy and to compare continuous heart rhythm surveillance versus 24HM follow-up intraindividually, we evaluated a novel implantable continuous cardiac rhythm monitoring (IMD) device (Reveal XT 9525). Methods and Results-Forty-five cardiac surgical patients (male 37, mean age 69.7Ϯ9.2 years) with a mean preoperative AF duration of 38Ϯ45 m were treated with either left atrial epicardial high-intensity focus ultrasound ablation (nϭ33) or endocardial cryothermy (nϭ12) in case of concomitant mitral valve surgery. Rhythm control readings were derived simultaneously from 24HM and IMD at 3-month intervals with a total recording of 2021 hours for 24HM and 220 766 hours for IMD. Mean follow-up was 8.30Ϯ3.97 m (range 0 to 12 m). Mean postoperative AF burden (time period spent in AF) as indicated by IMD was 37Ϯ43%. Sinus rhythm was documented in 53 readings of 24HM, but in only 34 of these instances by the IMD in the time period before 24HM readings (64%, PϽ0.0001), reflecting a 24HM sensitivity of 0.60 and a negative predictive value of 0.64 for detecting AF recurrence. Conclusion-For "real-life" cardiac rhythm documentation, continuous heart rhythm surveillance instead of any conventional 24HM follow-up strategy is necessary. This is particularly important for further judgment of ablation techniques, devices as well as anticoagulation and antiarrhythmic therapy. (Circulation. 2009;120[suppl 1]:S177-S184.)

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Absence of Correlation Between Symptoms and Rhythm in “Symptomatic” Atrial Fibrillation

Cited by 40 publications

References 9 publications

What patients want and need to know about atrial fibrillation

What patients want and need to know about atrial fibrillation

Ablation of paroxysmal atrial fibrillation during coronary artery bypass grafting: 12 months’ follow-up through implantable loop recorder

Twenty-Four–Hour Holter Monitor Follow-Up Does Not Provide Accurate Heart Rhythm Status After Surgical Atrial Fibrillation Ablation Therapy

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