Introduction
Catheter ablation for the treatment of atrial fibrillation (AF) has
emerged as a safe1 and superior strategy compared to
antiarrhythmic drug therapy in reducing AF
recurrence2,3,4, improving quality of life5,6 , and reducing mortality and hospitalizations in
patients with heart failure and reduced ejection
fraction7,8. Expert consensus statements recommend
that recurrence of AF be defined as any AF, atrial tachycardia (AT) or
atrial flutter (AFL) of at least 30 seconds duration detected more than
3 months (i.e. the blanking period) following catheter
ablation9. Success of the procedure varies depending
on how success is defined, with significant differences in outcome
definitions based on required AF duration as well as the monitoring
strategy employed to detect treatment
failure10,11,12,13. Furthermore, some authors have
suggested that a reduction in AF burden may be a more objective endpoint
rather than a binary outcome of recurrence as a measure of
success14. This may be even more important given
emerging data correlating AF duration and burden with risk of stroke15,16,17,18, a risk which may be attenuated in part by
AF ablation19. The present exploratory analysis used a
large de-identified electronic health record (EHR) dataset to assess how
variations in defining AF recurrence and frequency and duration of
monitoring influence an assessment of treatment success or failure.