Accuracy of atrial fibrillation detection by an insertable cardiac monitor in patients undergoing catheter ablation: Results of the <scp>BioVAD</scp> study

Assaf, Amira; Theuns, Dominic; Sakhi, Rafi; Bhagwandien, Rohit; Szili-Török, Tamás; Yap, Sing‐Chien

doi:10.1111/anec.12960

Cited by 5 publications

(5 citation statements)

References 27 publications

(40 reference statements)

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“…This is a relatively new application of ICM, typically in patients after AF ablation, in whom clarification of AF burden can influence disease managment. 1 , 4 , 5 , 11 , 12 Nearly 1 in 5 patients underwent a repeat ablation during the relatively short follow-up period in our study, suggesting that the ICM can have a relevant influence on the management of these patients. Interestingly, there was a relatively high yield of cardiac conduction abnormalities or ventricular arrhythmia in this cohort, resulting in implantation of cardiac implantable electronic devices.…”

Section: Discussionmentioning

confidence: 70%

Diagnostic yield of an insertable cardiac monitor in a large patient population

Lau¹,

Pierre²,

Cabañas³

et al. 2023

Heart Rhythm O2

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Section: Discussionmentioning

confidence: 70%

Diagnostic yield of an insertable cardiac monitor in a large patient population

Lau¹,

Pierre²,

Cabañas³

et al. 2023

Heart Rhythm O2

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“…These devices showed different diagnostic accuracy ranging from 90% to 100% according to the type of detected arrhythmias and the calculation methods (Table 4). 9,20–22 …”

Section: Resultsmentioning

confidence: 99%

False‐positive alarms in patients with implantable loop recorder followed by remote monitoring: A systematic review

Covino,

Russo

2024

Pacing Clinical Electrophis

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Remote Monitoring (RM) has been shown to provide useful information about arrhythmic events in patients with implantable loop recorders (ILRs), however there is few and conflicting data about the false positive (FP) alarms burden and characteristics among ILR recipients. The aim of the present systematic review was to evaluate incidence and characteristics of FP alarms among ILR patients followed by RM. We developed a systematic research in Embase, MEDLINE and PubMed databases and selected all papers focused on false positive ILR transmissions published from June 01, 2013 to June 01, 2023. Case reports, meeting summaries, posters and simple reviews were excluded. Twelve reports were finally selected, including five prospective and seven retrospective studies. Information about population characteristics, device type and setting, overall transmissions and FP alarms and any adopted strategies to reduce them were extracted from an overall population of 3.305 patients. FP alarms were 59.7% of the overall remote transmissions and were found in 1/5 of the analyzed population. FP alarms for atrial fibrillation were the most common cause of false transmissions and were mainly due to premature atrial and ventricular complexes. No clinical predictors of FP alarms were identified, except for nonparasternal ILR implantation site. Since the overload work due to FP alarms might reduce the benefit of remote monitoring of ILR patients, the device optimization is an important step until an help from machine‐learning algorithms is available.

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“…In our study, atrial fibrillation and HVR were common findings in patients implanted for atrial fibrillation management, with estimated incidences of 36 and 39%, respectively, at 18 months. This is a relatively new and not yet fully established indication for ICM, especially in patients after transcatheter ablation, where quantification of the atrial fibrillation burden can influence disease management 2,23 . As atrial fibrillation recurrences are often asymptomatic after the first ablation, continuous and long-term monitoring can become important in selected patients to guide decisions on repeated procedures or antiarrhythmic drug management 24,25 .…”

Section: Discussionmentioning

confidence: 99%

“…This is a relatively new and not yet fully established indication for ICM, especially in patients after transcatheter ablation, where quantification of the atrial fibrillation burden can influence disease management. 2,23 As atrial fibrillation recurrences are often asymptomatic after the first ablation, continuous and long-term monitoring can become important in selected patients to guide decisions on repeated procedures or antiarrhythmic drug management. 24,25 We observed a high prevalence of atrial fibrillation ablation procedures (21.6%) and We also observed a 14.8% incidence of atrial fibrillation at 18 months patients implanted for cryptogenic stroke, leading to anticoagulant initiation and, in one case, to atrial fibrillation ablation.…”

Section: Anticipated Arrhythmic Diagnoses and Treatmentsmentioning

confidence: 99%

Incidental and anticipated arrhythmic diagnoses in patients with an implantable cardiac monitor

Maines,

Rotondi,

Guarracini

et al. 2024

Journal of Cardiovascular Medicine

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Aims In this study, we investigated a cohort of unselected patients with various indications for an implantable cardiac monitor (ICM). Our main objectives were to determine the incidence of arrhythmic diagnoses, both anticipated and incidental in relation to the ICM indication, and to assess their clinical relevance. Methods We examined remote monitoring transmissions from patients with an ICM at four Italian sites to identify occurrences of cardiac arrhythmias. Concurrently, we collected data on medical actions taken in response to arrhythmic findings. Results The study included 119 patients, with a median follow-up period of 371 days. ICM indications were syncope/presyncope (46.2%), atrial fibrillation management (31.1%), and cryptogenic stroke (22.7%). In the atrial fibrillation management group, atrial fibrillation was the most common finding, with an incidence of 36% [95% confidence interval (CI) 22–55%] at 18 months. Rates of atrial fibrillation were not significantly different between patients with cryptogenic stroke and syncope/presyncope [17% (95% CI 7–40%) vs. 8% (95% CI 3–19%), P = 0.229]. For patients with cryptogenic stroke, the incidence of asystole and bradyarrhythmias at 18 months was 23% (95% CI 11–45%) and 42% (95% CI 24–65%), respectively, similar to estimates obtained for patients implanted for syncope/presyncope (P = 0.277 vs. P = 0.836). Overall, 30 patients (25.2%) required medical intervention following ICM-detected arrhythmias, predominantly involving atrial fibrillation ablation (10.9%) and medication therapy changes (10.1%). Conclusion In a real-life population with heterogeneous insertion indications, approximately 25% of patients received ICM-guided medical interventions within a short timeframe, including treatments for incidental findings. Common incidental arrhythmic diagnoses were bradyarrhythmias in patients with cryptogenic stroke and atrial fibrillation in patients with unexplained syncope.

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Accuracy of atrial fibrillation detection by an insertable cardiac monitor in patients undergoing catheter ablation: Results of the BioVAD study

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 5 publications

References 27 publications

Diagnostic yield of an insertable cardiac monitor in a large patient population

Diagnostic yield of an insertable cardiac monitor in a large patient population

False‐positive alarms in patients with implantable loop recorder followed by remote monitoring: A systematic review

Incidental and anticipated arrhythmic diagnoses in patients with an implantable cardiac monitor

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