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Minerva Cardiology and Angiology 2022 Feb 25

DOI: 10.23736/S2724-5683.22.05859-8


language: English

Recurrence of atrial fibrillation post-ablation: which is the most effective approach for detection?

Michela CASELLA 1, 2, Paolo COMPAGNUCCI 1 , 3 , Manuel A. CONTI 1, Umberto FALANGA 1, 3, Giovanni VOLPATO 1, 3, Marco FOGANTE 2, Laura CIPOLLETTA 1, Agostino MISIANI 1, Silvano MOLINI 1, Andrea GIOVAGNONI 2, Antonio DELLO RUSSO 1, 3

1 Cardiology and Arrhythmology Clinic, University Hospital Ospedali Riuniti, Ancona, Italy; 2 Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy; 3 Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy

Over the last 20 years, catheter ablation of atrial fibrillation (AF) has evolved from a research tool into a fundamental therapeutic measure, with the potential to improve symptoms, quality of life, and even risk of major adverse cardiac events (among patients with heart failure and a reduced ejection fraction). Notwithstanding the tremendous evolution in techniques and tools, risk of AF recurrences post-ablation is not negligible, and a comprehensive structured follow-up is highly needed to deliver optimal patient care. In this follow-up process, monitoring of heart rhythm is quintessential to detect recurrences, and may be accomplished by means of symptoms-triggered, intermittent, or continuous monitors. In recent years, the development and widespread adoption of implantable cardiac monitors, by allowing continuous long-term rhythm assessment, has surged to become the gold-standard strategy, both in research settings and in clinical practice. In this review, we both summarize the present state-of-the art on the detection of post-ablation AF recurrences, and provide future perspectives on this emerging yet often neglected topic, aiming to give practical hints for evidence-based, personalized patient care.

KEY WORDS: Atrial fibrillation; Catheter ablation; Recurrences; Cardiac monitors; Loop recorder

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