Introduction
Surgical and catheter ablation of atrial fibrillation (AF) have emerged
as a safe1 and effective alternative to antiarrhythmic
drug therapy2–4,5,67,8,9,10. The perceived success
rate of these procedures is highly dependent on the duration of AF
recurrence that defines treatment failure as well as the intensity and
duration of monitoring11–14. Historically, clinical
trials have used varying cutoffs of AF recurrence with varying methods
to detect the endpoint. Society guidelines define AF recurrence as any
AF, atrial tachycardia (AT) or atrial flutter (AFL) of at least 30
seconds after a 90-day blanking period15, a definition
that has traditionally been tested with intermittent ECGs and Holter
monitors performed at fixed intervals or with symptoms. With the rapid
expansion of direct to consumer monitoring technologies, the ease of
patient reported self-monitoring of AF recurrences post-intervention has
already started to shift the paradigm towards a more patient- facing
approach.