Very-early detection of atrial fibrillation after ablation evaluated by a wearable ECG-patch predicts late blanking period recurrence: Preliminary data from a prospective registry

Abstract

IntroductionAtrial fibrillation (AF) ablation represents a safe and effective procedure to restore sinus rhythm. The idea that post-procedural AF episodes - during theblanking period-are not considered treatment failure has been increasingly challenged. The E-Patch, a single-use adhesive electrode, facilitates extended continuous ECG monitoring for 120 h. This pilot study aims to assess the effectiveness of this ambulatory monitoring device and investigate whether very-early AF recurrence correlates with delayed blanking period ablation outcomes. MethodsWe conducted a single-center, prospective, longitudinal study, including consecutive post-ablation patients monitored with the E-patch. The ability of the device to continuously record was analyzed, as well as the occurrence of AF episodes during external 7-day loop-recorder in the 2nd-month post-ablation. ResultsWe included 40 patients, median age 62 years (IQR 56–70). E-Patch monitoring was obtained for a median of 118 h (IQR 112–120), with no discomfort nor interpretation artefacts. Very-early AF recurrence was detected in 11 (27.5 %) patients, with a median AF burden of 7 % (IQR 6 %–33 %). Late-blanking period AF was detected in 13 (33 %) of theexternal 7-day looprecordings.Of the 11 patients that had very-early AF recurrence, 10 (91 %) had late-blanking AF. Very-early AF detectionshowed77 % (95 % CI 64 %-90 %) sensitivityand 96 % (95 % CI 90–100 %) specificity inpredictinglate-blanking AF, with a non-parametric ROCcurve AUC of 0.903 (95 % 0.797––1.0). ConclusionThe E-Patch was able to detect very-early AF during an extended period. Very-early AF detection emerges as a predictor of AF recurrence during the late blanking period post-ablation.