Recurrence of atrial fibrillation post catheter ablation or cardioversion using cardiac implantable electronic device data

Introduction:
Atrial fibrillation (AF) remains a leading cause of decreased quality of life and increased mortality worldwide. The unpredictable nature of AF makes it challenging to detect episodes, particularly after interventional treatments like catheter ablation or cardioversion. Current literature offers limited insights into real-world outcomes of AF management, especially in cases where continuous monitoring is possible through cardiac implantable electronic devices (CIEDs). This audit aims to evaluate the recurrence of AF in patients undergoing catheter ablation versus cardioversion, using remote monitoring data from CIEDs and to assess any correlation with patients' prior interventional backgrounds.

Methods:
This retrospective, observational departmental audit analysed patients equipped with specific CIEDs capable of remote monitoring who underwent either catheter ablation or cardioversion between 2016 and 2023. Data from the CIED remote monitoring systems were used to assess the recurrence of AF.

Results:
A total of 108 patients were included in the study. The recurrence rate of AF was significantly lower in the catheter ablation group (55%) compared to the cardioversion group (77%). Additionally, patients with a history of previous rhythm-control interventions had a recurrence rate of 73%, compared to 60% in those without such a history, though this difference did not reach statistical significance.

Conclusion:
The findings suggest that CIED remote monitoring is a reliable method for evaluating the success of rhythm-control treatments, with catheter ablation showing a better outcome compared to cardioversion. Patient background did not significantly impact the likelihood of remaining free from AF, emphasizing the need for individualized, long-term follow-up strategies.