title: Role of extended external auto-triggered loop recorder monitoring for atrial fibrillation.
abstract: BACKGROUND
  Clinical outcomes after atrial fibrillation (AF) ablation are evaluated using standard 24-h Holter monitoring, and the large spontaneous variability of AF episodes and incidence of silent AF are major limitations. Further, symptoms generally decrease after AF ablation. METHODS AND RESULTS: Newly developed extended external auto-trigger loop recorders (ELR) were used for 14-day consecutive monitoring to detect atrial tachyarrhythmia (ATa). Continuous tracings were stored for the initial 24h. Among 500 examinations after AF ablation in 342 patients, 40 ATa episodes were manually detected in 25 patients during the initial 24h. All episodes including 27 asymptomatic episodes (67.5%) were successfully identified using ELR. Recurrent ATa after AF ablation were detected in 83 patients, and a median monitoring duration of 4.0 days (IQR, 1.0-7.75 days) was required to detect the first episode of recurrence. The sensitivity of 24-h monitoring in detecting arrhythmia recurrence was 27.7% relative to the 14-day monitoring. The diagnostic yield gradually improved with longer monitoring duration regardless of the period after the ablation procedure. Longer follow-up, however, was required to obtain similar diagnostic yield >1 year after as compared to <1 year after the procedure.
  
  
  CONCLUSIONS
  Twenty-four-hour monitoring detected a part of the ATa recurrences after ablation procedures. Extended ELR enabled arrhythmia monitoring for longer, with higher diagnostic yield of recurrence, regardless of patient symptoms.
authors.affiliation: Cardiovascular Center, Tsuchiura Kyodo Hospital.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Takagi
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kusa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Noboru
authors.initials: N
authors.lastname: Ichihara
authors.forename: Jin
authors.initials: J
authors.lastname: Iwasawa
authors.forename: Akio
authors.initials: A
authors.lastname: Kuroi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hachiya
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hirao
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Iesaka
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000628:therapy; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis / Q000503:physiopathology