Cardiovascular Implantable Electronic Devices -> Monitoring & Outcomes: -> Monitoring & Follow-up D-PO05 - Poster Session V (ID 39) Poster

D-PO05-090 - Utility Of Implantable Loop Recorder For Augmenting Detection Of New Onset Atrial Fibrillation In Patients Undergoing Typical Atrial Flutter Ablation (ID 543)


Background: Patients undergoing typical atrial flutter (AFL) ablation remain at high risk for future development of atrial fibrillation (AF). Conventional monitoring (CM), which utilizes outpatient ECGs and intermittent holter or trans-telephonic monitors over extended follow-up periods, has shown AF incidence rates of 18-50% in these patients.
Objective: We evaluated whether continuous monitoring using implantable loop recorders (ILRs) would enhance AF detection beyond CM in this patient population.
Methods: Retrospective review was performed for veteran patients undergoing AFL ablation between 2002 and 2019 who completed at least 6 months of follow-up after the procedure. We compared AF detection rates between patients who had CM versus those who received ILR (LINQ, Medtronic) immediately following AFL ablation.
Results: A total of 217 patients (age: 66±9 years; all male) were included. Mean follow-up duration after AFL ablation was 4.6±3.5 years using CM in 172 (79%) and ILR in 45 (21%) patients. Seventy-nine patients (36%) developed new onset AF which was detected by CM in 51 and ILR in 28 (30% vs 62% respectively, p<0.001). ILR detected AF at 10±8 months after AFL ablation which was earlier than that detected by CM (44±33 months; p=<0.01). Figure A shows AF free survival for the entire cohort and Figure B shows AF detection rates by CM vs ILR at different follow-up time periods.
Conclusion: Patients undergoing AFL ablation remain at an incremental risk of developing AF which is detected sooner and more often by ILR than CM. Earlier AF detection may be useful for optimizing rhythm management strategies and minimizing adverse event rates in this patient population.