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Arrhythmia Monitoring

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Mark: patient case

Questions in managing AF

In charge

Clinical studies

Efficient from implant to follow-up


Cardiac Diagnostics and Monitoring

Syncope Diagnosis

Arrhythmia Monitoring
   
   
   
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Clinical studies

Recurring episodes of AT/AF require continuous monitoring

  • The highly variable recurrence patterns of AT/AF episodes do not lend themselves to accurate monitoring on a non-continuous basis.
  • Long-term monitoring with an implantable device eliminates many patient compliance or tolerance concerns of conventional external monitoring systems.

Certainty on absence of AF

Conclusion

Non-continuous monitoring provides inaccurate assessments of AT/AF burden, compared to continuous monitoring with the implantable device used in the study. The implanted device records daily AT/AF burden with a sensitivity of over 95%.


P.D. Ziegler et al. Heart Rhythm. 2006; 3:1445-1452


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Long-term monitoring after AF ablation is more accurate

  • Long-term transtelephonic ECG or repetitive 7-day ECG monitoring is more accurate than short-term standard ECG or 24h Holter monitoring in measuring AF recurrence after ablation and providing adequate information on your patient's AF status.

Freedom from AF, post PVI-procedure

Long-term transtelephonic ECG or repetitive 7-day ECG monitoring is more accurate than short-term standard ECG or 24h Holter monitoring in measuring AF recurrence after ablation and providing adequate information on your patient's AF status.

Conclusion

Short-term monitoring detects fewer recurrent AF-episodes than long-term monitoring. Reported results after catheter ablation may depend on the methods used for follow-up.

G. Senatore et al. JACC. 2005; 45:873-876
H. Kottkamp et al. JACC. 2004; 44:869-877
H. Kottkamp, Medtronic SQDM Symposium, Barcelona, March 2007


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What your AF patients cannot tell you

  • 45% of patients who reported symptoms that were associated with AF did not have a documented atrial tachyarrhythmia that coincided with the symptoms.
  • Almost 95% of documented atrial tachyarrhythmia episodes are asymptomatic.

Differentiation of specific symptoms during AF and SR (in total numbers)

Differentiation of specific symptoms during AF and SR (in total numbers)

Conclusion

Poor correlation between symptoms and atrial tachyarrhythmia. Symptoms were reported in only 46%of the cases where AF was confirmed by ECGs When analyzing all symptom-triggered ECGs,AF was diagnosed in only 37%.

M.Patten et al. J Cardiovasc Electrophysiol. 2006; 17:1216-1220
A.A.Strickberger et al. Heart Rhythm 2005; 2:125-131


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The pattern of AF recurrence is unpredictable

  • Despite optimized antiarrhythmic therapy, patients show
    a high incidence of recurrent AF.
  • Freedom from AF for more than 3 months does not preclude
    subsequent long-lasting AF recurrence.

Detection of AF by ECG recording during follow-up versus information
from the implanted device

Detection of AF by ECG recording during follow-up versus information

Conclusion

Only long-term continuous monitoring gives the full picture of AF.

C.W.Israel et al. J Am Coll Cardiol.2004;43:47-52



Page created: 23 July 2007. Last reviewed: 23 July 2007.



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