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Recurrent atrial fibrillation/flutter detection after ablation or cardioversion using the AliveCor KardiaMobile device: iHEART results
Author(s) -
Goldenthal Isaac L.,
Sciacca Robert R.,
Riga Teresa,
Bakken Suzanne,
Baumeister Maurita,
Biviano Angelo B.,
Dizon Jose M.,
Wang Daniel,
Wang Ketty C,
Whang William,
Hickey Kathleen T.,
Garan Hasan
Publication year - 2019
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14160
Subject(s) - medicine , atrial flutter , atrial fibrillation , hazard ratio , cardiology , confidence interval , ablation , catheter ablation , randomized controlled trial , cardioversion
Objective This study evaluated the impact of daily ECG (electrocardiogram) self‐recordings on time to documented recurrent atrial fibrillation (AF) or atrial flutter (AFL) and time to treatment of recurrent arrhythmia in patients undergoing catheter radiofrequency ablation (RFA) or direct current cardioversion (DCCV) for AF/AFL. Background AF recurrence rates after RFA and DCCV are 20% to 45% and 60% to 80%, respectively. Randomized trials comparing mobile ECG devices to standard of care have not been performed in an AF/AFL population after treatment. Methods Of 262 patients consented, 238 were randomized to either standard of care (123) or to receive the iHEART intervention (115). Patients in the intervention group were provided with and trained to use an AliveCor KardiaMobile ECG monitor, and were instructed to take and transmit daily ECG recordings. Data were collected from transmitted ECG recordings and patients’ electronic health records. Results In a multivariate Cox model, the likelihood of recurrence detection was greater in the intervention group (hazard ratio = 1.56, 95% confidence interval [CI]: 1.06‐2.30, P = .024). Hazard ratios did not differ significantly for RFA and DCCV procedures. Recurrence during the first month after ablation strongly predicted later recurrence (hazard ratio = 4.53, 95% CI: 2.05‐10.00, P = .0006). Time from detection to treatment was shorter for the control group (hazard ratio = 0.33, 95% CI: 0.57‐2.92, P < .0001). Conclusions The use of mobile ECG self‐recording devices allows for earlier detection of AF/AFL recurrence and may empower patients to engage in shared health decision‐making.