The Importance of Arrhythmia Burden for Outcomes and Management Related to Catheter Ablation of Atrial Fibrillation

Abstract

Author's summary This article addresses the unmet need of understanding the clinical significance of atrial fibrillation (AF) burden in measuring the outcomes of catheter ablation. We show how AF burden correlates to ablation success better than dichotomous definitions of success and failure. We also show that AF burden quality of life and even risk of stroke.

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

“…after catheter ablation remains to be determined,(Hindricks et al, 2021 ; Calkins et al, 2017 ) reduction in AF burden seems to be a more accurate reflection of procedural success than a single AF recurrence. (Sanchez‐Somonte et al, 2021 ; Verma et al, 2013 ) Improvement in quality of life (QOL) post‐ablation is better correlated with reduction in AF burden than AF recurrence. (Mantovan et al, 2013 ; Blomstrom‐Lundqvist et al, 2019 ; Terricabras et al, 2020 ) Many patients experience an improvement in QOL post‐ablation without total elimination of AF.…”

“…(Andrade et al, 2019 ; Andrade et al, 2021 ; Perez‐Castellano et al, 2014 ) Continuous monitoring provides the opportunity to establish the AF burden, which may have a better correlation with functional outcome than mere documentation of AF recurrence by intermittent rhythm monitoring strategies. (Andrade et al, 2020 ; Sakhi et al, 2019 ; Sanchez‐Somonte et al, 2021 ) Furthermore, intermittent Holter monitoring not only has a lower sensitivity but paradoxically may also overestimate the AF burden in those with AF recurrence. (Aguilar et al, 2022 ) As AF burden may play a more important role in the evaluation of novel ablation techniques, it is important that the AF burden provided by ICMs is accurate.…”

“…rence (Sanchez-Somonte et al, 2021;Verma et al, 2013). Improvement in quality of life (QOL) post-ablation is better correlated with reduction in AF burden than AF recurrence (Mantovan et al, 2013;Blomstrom-Lundqvist et al, 2019;Terricabras et al, 2020).…”

What Is Better Predictor of Late Recurrence after Radiofrequency Catheter Ablation for Atrial Fibrillation?

“…There are several risk factors to predict clinical outcomes in patients with atrial fibrillation (AF) after radiofrequency ablation (RFCA) including AF burden, type of AF. 1) However, In fact, it is known that the degree of anatomical and electrical remodeling is more important to predict the prognosis of AF after RFCA. 2) There are several mechanism of atrial fibrosis that cause atrial arrhythmias including abnormal trigger, automatic activity and predisposing conduction delay for reentry circuit.…”

Rare and Elusive Arrhythmia: Atrial Tachycardia From Noncoronary Aortic Cusp During Catheter Ablation for Atrial Fibrillation

“…In a considerable number of patients, catheter ablation for AF reduces AF burden. 6) However, in a small number of patients, atrial tachycardia (AT) and atypical atrial flutter occur after catheter ablation for AF. 7) Because those atrial tachyarrhythmias tend to make rapider ventricular response and be more symptomatic than AF, the patients suffer severely.…”