CORRELATION BETWEEN HEART RHYTHM AND SYMPTOMS IN PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION AFTER CATHETER ABLATION AND ANTIARRHYTHMIC THERAPY BASED ON DATA OBTAINED FROM IMPLANTABLE CARDIAC MONITORS

Abstract

Purpose: to reveal a correlation between the symptoms and heart rhythm as well as to evaluate the incidence of symptomatic and asymptomatic paroxysmal atrial fibrillation (AF) in patients with paroxysmal AF after catheter ablation and antiarrhythmic drug therapy (AAD) through long-term observation based on data from implantable cardiac heart monitors (ICM). Materials and Methods: 92 patients with paroxysmal AF were randomly broken into two groups: 1) AF catheter ablation + ICM (Group I; n=46); 2) AAD + ICM (Group II; n=46). The data recorded by the device were matched against the symptoms diaries kept by the patients. Results: through the follow-up period (24 months), 17 (40%) patients of the catheter ablation Group and another 33 (71.8%) patients belonging to the AAD Group had AF relapse, whereas in 4 (23.5%) patients of the catheter ablation group and in 1 (3%) patients of the AAD group the paroxysms were asymptomatic. Only 30% of episodes recorded by the ICM in the AF catheter ablation + ICM Group and 78% of episodes in patients receiving AAD + ICM were found to be true AF paroxysms. Summary: the rhythm status did not match the patients’ symptoms in terms of AF, which was observed in 70% of the cases after catheter ablation and in 22% of cases in the AAD group. Asymptomatic AF was more common among the patients belonging to the catheter ablation group (23.5%) if compared to those who underwent AAD (3%). The subjective evaluation of the symptoms done by the patients regarding their arrhythmia did not reflect the true state of things related to the heart rhythm, which makes such evaluation not reliable if employed to judge the treatment efficiency.