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- W1570330107 abstract "Symptom-guided assessment, associated with 24hour Holter monitoring, has been the strategy used by authors of the major published papers reporting the results of catheter ablation of AF2,3. In studies using long-term rhythm monitoring through seven-day Holter or daily transtelephonic ECG transmissions, the number of recurrences in asymptomatic patients was found to be signifi cantly higher4,5. The use of a more sensitive method to establish the actual success rate of AF ablation procedures is not only desirable, but also the cornerstone of the decision regarding anticoagulation therapy discontinuation, taking into account the risk of embolic events. Thus, daily transtelephonic monitoring during one year has already been used by the latest scientifi c studies for a more reliable evaluation of AF ablation effectiveness6,7. However, this monitoring strategy with daily sampling of heart rhythm is not practical for longterm use. In addition, it has some limitations regarding recurrence evaluation, since it provides intermittent recording, and asymptomatic and self-limited episodes may be missed. In our opinion, the choice of a method to evaluate success depends on the patient’s clinical characteristics. In young, symptomatic subjects with paroxysmal atrial fi brillation but no risk factors for embolic phenomena, in which the procedure is intended to improve quality of life, symptom-guided assessment associated with 24-hour Holter seems to be quite acceptable for clinical follow-up. Yet, this conduct is not appropriate for patients at high risk of embolism. Theoretically, in view of the limitations of the monitoring systems described above, these patients should be kept indefi nitely anticoagulated. An alternative would be continuous, long-term ECG monitoring over the years showing absence of atrial fi brillation. Currently, this monitoring system is available only in pacemakers with AF detection algorithm and implantable loop recorders, even though no prospective studies have been made showing either the effi cacy or cost-effectiveness of these technologies8,9." @default.
- W1570330107 created "2016-06-24" @default.
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- W1570330107 date "2006-05-01" @default.
- W1570330107 modified "2023-10-17" @default.
- W1570330107 title "Avaliação da recidiva da fibrilação atrial após ablação da veia pulmonar por radiofreqüência baseada em sintomas: esta é uma estratégia confiável?" @default.
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- W1570330107 doi "https://doi.org/10.1590/s0066-782x2006000500015" @default.
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