Role of transtelephonic electrocardiographic monitoring in detecting short-term arrhythmia recurrences after radiofrequency ablation in patients with atrial fibrillation.
OBJECTIVE
The aim of our study was to determine the incidence of asymptomatic recurrences of atrial fibrillation (AF) by daily transtelephonic (TT) electrocardiographic (ECG) monitoring, as compared with standard ECG and 24-h Holter recording, in patients who underwent radiofrequency catheter ablation (RCA) of AF.


BACKGROUND
The efficacy of RCA of AF is usually evaluated by means of patients' symptoms.


METHODS
Seventy-two patients with paroxysmal (n = 37) or persistent (n = 35) drug-refractory AF underwent circumferential RCA of the pulmonary vein (PV) ostia. Left isthmus ablation was performed in 57 patients, and cavotricuspid isthmus ablation was done in 69 patients. Patients were scheduled to obtain an ECG and Holter recordings one and four months after ablation, as well as a daily TT ECG, from 30 to 120 days after ablation or in the event of symptoms.


RESULTS
A total of 5,585 TT ECGs were obtained (mean 77.5 per patient). In 20 patients (27.8%), AF recurrences were recorded during TT ECG, whereas ECG and Holter monitoring revealed AF recurrences in 10 patients (13.9%, p = 0.001). Ten patients had at least one asymptomatic AF recurrence, and eight were completely asymptomatic. The ECG recorded in the event of symptoms always showed AF.


CONCLUSIONS
Transtelephonic ECG is better than standard ECG and 24-h Holter recordings in evaluating AF relapses after RCA, thus decreasing the short-term success of ablation from 86% to 72%. The absence of symptoms should not be interpreted as absence of AF, as 50% of patients were asymptomatic during at least one AF episode.
Senatore
Gaetano
G
Divisione di Cardiologia, Ospedale Civile di Cirie' (TO), Cirie', Italy. senatoreg@libero.it
Stabile
Giuseppe
G
Bertaglia
Emanuele
E
Donnici
Giovanni
G
De Simone
Antonio
A
Zoppo
Franco
F
Turco
Pietro
P
Pascotto
Pietro
P
Fazzari
Massimo
M
D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D017115:Catheter Ablation; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011667:Pulmonary Veins / Q000601:surgery; D012008:Recurrence; D013685:Telecommunications; D013997:Time Factors; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents