The Role of Continuous Monitoring in Atrial Fibrillation Management

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is strongly associated with stroke risk and a variety of cardiovascular conditions. AF early detection is of paramount importance, in order to define proper medical treatment. This can be challenging due to the often silent and intermittent nature of the rhythm disturbance. Long-term external ECG monitoring may be very helpful, but if less than fully continuous and of long duration it will be not reliable. For this reason continuous monitoring is of increased importance, and outcome measurements of AF treatment trials will be based on the AF burden detected by insertable cardiac monitors (ICM) or therapeutic devices such as pacemakers or ICDs, leading to the paradigm that the detection of AF in the presence of thromboembolic risk factors should be performed wherever possible in order to improve patients' chances.