title: Implantable loop recorder monitoring after concomitant surgical ablation for atrial fibrillation (AF): insights from more than 200 continuously monitored patients.
abstract: Different follow-up methods have been used to report success rates after AF ablation. Recent studies have shown that intermittent rhythm monitoring underestimates the actual AF recurrence rate. We therefore report our experience with continuous rhythm monitoring by implantable loop recorder (ILR) in a large patient cohort. Between 09/2008 and 12/2012, 343 cardiac surgical patients underwent concomitant surgical AF ablation. ILR implantation was performed in 206 patients. ILR interrogation was accomplished at 3, 6 and 12 months postoperatively. Successful ablation was defined as AF Burden <0.5 %. Primary outcome of the study was freedom from AF at 12-month follow-up. Mean patient's age was 70.5 ± 7.4 years. No major ablation- or ILR-related complications occurred. In 4 patients (1.9 %) ILR had to be explanted due to ILR-related wound infection (n = 2) or chronic pain (n = 2). Survival rate at 1-year follow-up was 96.6 %. Freedom from AF rate after 1-year follow-up was 68.5 and 63.6 % off antiarrhythmic drugs, respectively. Statistically significant predictors for successful ablation at 1-year follow-up were smaller LA diameter, shorter duration of AF and preoperative paroxysmal AF. Demographic data, indication for surgery, lesion set and used energy source had no impact on freedom from AF after 1 year. Continuous ILR monitoring after concomitant surgical AF ablation was safe and feasible, with registered freedom from AF rate of 68.5 % at 1-year follow-up. Thus continuous rhythm monitoring provides reliable outcome data and helps to guide antiarrhythmic therapy.
authors: Department of Cardiovascular Surgery, University Heart Center Hamburg, Martinistr. 52, 20246, Hamburg, Germany. s.pecha@uke.de.
authors: Simon
authors: S
authors: Pecha
authors: Department of Cardiology, St. Adolf-Stift Hospital Reinbek, Reinbek, Germany.
authors: Muhammet Ali
authors: MA
authors: Aydin
authors: Department of Cardiovascular Surgery, University Heart Center Hamburg, Martinistr. 52, 20246, Hamburg, Germany.
authors: Teymour
authors: T
authors: Ahmadzade
authors: Cardiology/Electrophysiology, University Heart Center Hamburg, Hamburg, Germany.
authors: Friederike
authors: F
authors: Hartel
authors: Cardiology/Electrophysiology, University Heart Center Hamburg, Hamburg, Germany.
authors: Boris
authors: B
authors: Hoffmann
authors: Cardiology/Electrophysiology, University Hospital Cologne, Cologne, Germany.
authors: Daniel
authors: D
authors: Steven
authors: Cardiology/Electrophysiology, University Heart Center Hamburg, Hamburg, Germany.
authors: Stephan
authors: S
authors: Willems
authors: Department of Cardiovascular Surgery, University Heart Center Hamburg, Martinistr. 52, 20246, Hamburg, Germany.
authors: Hermann
authors: H
authors: Reichenspurner
authors: Department of Cardiovascular Surgery, University Heart Center Hamburg, Martinistr. 52, 20246, Hamburg, Germany.
authors: Florian Mathias
authors: FM
authors: Wagner
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D017115:Catheter Ablation; D015716:Electrocardiography, Ambulatory / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Arrhythmia surgery; Atrial fibrillation; Implantable loop recorder monitoring; Surgical ablation of atrial fibrillation