Questions in managing AF

Answering questions you may have after AF ablation

“The only precise way of treating AF is knowing AF”
Prof.J. Ruskin, Boston, USA

Highly symptomatic
AF patients

Are patient symptoms related to arrhythmias?

AF was diagnosed in only 37% of all symptom-triggered ECGs. 1
When caring for patients with AF, listen to or trust the patient complaints, but don ’t make therapeutic changes until you can verify the rhythm.” 2

What are the AF details?

AF recurrence: The pattern in AF burden and the duration of the AF episodes influence the rhythm control and antiarrhythmia strategy
The ventricular response after AF influences the rate control strategy

Is AF truly absent?

The risk of recurrent AF after focal ablation is 30-50% over the first year and even higher when more than one pulmonary vein is involved. 3
Post ablation, 37% of patients have only asymptomatic AF recurrences, as opposed to 5% prior to ablation. 4

Can I confidently discontinue anticoagulation?

Absence of symptoms should not be interpreted as the absence of AF:
50% of patients with AF recurrence
after ablation have asymptomatic episodes. 5
Patients with AF recurrences lasting longer than one day were over three times more likely to suffer arterial embolism. 6

Which rate or rhythm control therapy should I prescribe?

Over 27% of ablation patients require more than one procedure. 7
“When caring for patients with atrial fibrillation, listen to or trust the patient’s complaints, but don’t make therapeutic changes until you can verify the rhythm.” 2

Should I adapt my AF management strategy?

Reveal may help you determine your AF management strategy by providing:

Accurate, long-term trending of AF daily burden
Verification and quantification of symptomatic and asymptomatic atrial arrhythmias

1 M.Patten et al. J Cardiovasc Electrophysiol. 2006; 17:1216-1220

2 K.A. Ellenbogen, M.A. Wood. Heart Rhythm. 2005; 2:132-133

3 A.S.Go et al, JAMA. May 9, 2001 2001;285;18:2370-2375

4 G. Hindricks et al. Circulation. 2005; 112-307:-313

5 G. Senatore et al. JACC. 2005; 45:873-876

6 A. Capucci et al. JACC. 2005; 46:1913-1920

7 R.Cappato et al. Circulation. 2005; 111:1100-1105

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