What long-term monitoring is required for patients who undergo atrial fibrillation (Afib) (AF) catheter ablation?

Updated: Apr 09, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Answer

Patients who undergo AF catheter ablation should be monitored for the signs and symptoms of potential complications, such as the following:

  • Cardiac perforation

  • Pericardial effusion

  • Cardiac tamponade

  • Vascular access complications

  • Pulmonary vein stenosis

  • Thromboembolism

  • Atrioesophageal fistula

  • Left atrial flutter/tachycardia

  • Phrenic nerve palsy

In addition, AF can recur and most episodes are asymptomatic. Therefore, it is important to monitor for signs and symptoms of recurrent AF in follow-up visits and to administer appropriate diagnostic tests if recurrence is suspected. In a prospective study (2011-2014)  that evaluated conventional intermittent Holter and electrocardiographic (ECG) monitoring for recurrent AF following surgical ablation with continuous monitoring via an implantable loop recorder (ILR) in 47 patients, compliance at 12 months was 93% for IRL, 76% for Holter monitoring, and 85% for ECG monitoring. [147] Moreover, detection of atrial tachyarrhythmias was equivalent between continuous monitoring with ILR and intermittent Holter and ECG monitoring. However, the investigators cautioned that these data were limited for broad use of continuous monitoring owing to a high rate of false-positive results (54%) and a limited number of events available for review (11%). [147]


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