부산대학교 도서관

Background:Unlike external ECG monitoring tools, an insertable cardiac monitor (ICM) has the ability to quantify burden of atrial fibrillation (AF), which has recently been demonstrated to be an important determinant of patient outcomes. The impact of catheter ablation on AF burden in a real-world population remains unknown.Objective:To determine the impact of catheter ablation on AF burden as measured by an ICM.Methods:The ongoing, observational, multi-center Reveal LINQ Registry evaluates the role of the ICM in the patient care pathway. Patients were included in this analysis if they had available AF burden data recorded by ICM, followed by catheter ablation for AF, and at least 6 months of follow-up data post-ablation. AF burden was defined as the percentage of time in AF detected by the device over the duration of the monitoring period. AF burden was not assessed during the 3 months post-ablation blanking period. AF burden reduction before and after ablation was tested using the Wilcoxon signed-rank test.Results:The cohort included 64 patients [62 ? 9 years; male (83%); paroxysmal AF, n=38 (59%)]. An AF ablation had also been performed prior to ICM insertion in 16 (25%) patients. Pre- and post-ablation ICM data were available for 5.2 ?5.0 and 16.8 +6.5 months, respectively. Ablation was associated with an 86.4% reduction in average AF burden (p<0.0001), from 24.1 ? 35.3%, (range 0-98.9%) pre-ablation to 3.3 ? 7.6%, (range 0-34.6%) post-ablation (Figure). No AF beyond the blanking period was observed in 14 (22%) patients.Conclusion:This analysis from a prospective real-world registry shows that catheter ablation is associated with a greater than 85% reduction in AF burden, which can only be determined using devices like an ICM that facilitate continuous ECG monitoring. Future trials are needed that incorporate AF burden as an endpoint to determine whether residual AF burden post-ablation correlates with patient outcomes.