ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2026
Pre-procedural time spent in atrial fibrillation using intermittent ECG monitoring is associated with arrhythmia recurrence after ablation: the ISOLATION cohort study.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsAtrial fibrillation (AF) is conventionally classified as paroxysmal or persistent. AF burden might better reflect response to rhythm-control interventions. This study evaluated the association between estimated pre-procedural time spent in AF and recurrences after AF ablation, compared with conventional AF classification. METHODS AND
resultsIn patients scheduled for AF ablation, clinical characteristics were collected before ablation, and 60-second single-lead ECGs were recorded three times daily (with additional symptom-triggered recordings) for four weeks. Pre-procedural time spent in AF was estimated as the number of days with detected AF divided by total monitoring days. The primary endpoint was AF recurrence between 3 and 12 months post-ablation. Of 302 patients (mean age 64 ± 9 years; 33% female), 201 (67%) had paroxysmal AF and 101 (33%) had persistent AF. After 12 months, recurrence rates were higher in persistent than in paroxysmal AF (37.6% vs. 24.4%, P & 0.01) and in patients with a higher (>32%) vs. lower (≤32%) percentage of time spent in AF (36.4% vs. 24.0%, P < 0.01). Notably, paroxysmal AF patients with a higher percentage of time in AF had recurrence rates comparable to those of patients with persistent AF. Pre-procedural percentage of time in AF independently predicted arrhythmia recurrence at 12-month follow-up (HR: 1.06; 95% CI: 1.0-1.1; P & 0.025).
conclusionA higher pre-procedural percentage of time spent in AF derived from 60-second single-lead ECGs is independently associated with atrial arrhythmia recurrence after ablation. Assessing the percentage of pre-procedural time spent in AF might help identify paroxysmal AF patients with a high AF recurrence risk in future studies.
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