Authors

Melodie Segura Domínguez1, Víctor Castro Urda2, Diego Jiménez Sánchez2, Cristina Aguilera Agudo2, Jorge Toquero Ramos2, Eusebio García-Izquierdo Jaén2, Jesús de Andrés Humanes3, Ana Antequera Guirado3, Paula Vela Martín4, Ignacio Fernández Lozano5.

Position

1 Graduada en Enfermería. Unidad de Arritmias. Servicio de Cardiología. Hospital Universitario Puerta de Hierro Majadahonda, Madrid.2 Médico adjunto de Cardiología. Unidad de Arritmias. Hospital Universitario Puerta de Hierro Majadahonda, Madrid. 3 Diplomados en Enfermería. Unidad de Arritmias. Hospital Universitario Puerta de Hierro Majadahonda, Madrid. 4 Médico Interno Residente. Servicio de Cardiología. Hospital Universitario Puerta de Hierro Majadahonda, Madrid. 5 Jefe de Sección. Unidad de Arritmias. Hospital Universitario Puerta de Hierro Majadahonda, Madrid.

Contact address

Melodie Segura Domínguez. Avda. Navacerrada 4, portal 4 Bajo B. Pozuelo de Alarcón. 28224 (Madrid)

Contact email: melodiesd.nudos@gmail.com

Abstract

Introduction and objective. The detection of atrial fibrillation recurrences after ablation is crucial, although most of them remain undetected. The aim of this study is to evaluate the diagnostic capability for detecting atrial fibrillation recurrences of an ECG portable device, followed by a nurse, and the patient‘s adherence to the device.
Methods. We conducted a prospective observational study with patients included in the CAVAC-AF study, who received an ECG portable device. Patients were instructed to perform a daily and a symptom–guided electrocardiogram (extra electrocardiogram). Review and classification of electrocardiograms was performed by a trained nurse.
Results. A total of 45 patients were enrolled and had a mean follow-up of 181.5 days (±91.48). We received 7162 records: 96.31% were routine daily electrocardiograms and only 0.43% were not interpretable. The median adherence was 92.95% (IQR 26.44), being significantly superior in women (96.74% vs 82.22; p=0.038), with a superiority trend in paroxysmal vs. persistent atrial fibrillation (94.87% vs 79.53%; p=0.069) and in patients >62 years of age (94.89% vs 78.43%; p=0.068). A total of 330 atrial fibrillation records were detected (4.6%) in 14 patients (31.1%). Atrial fibrillation was recorded significantly more frequently in extra electrocardiograms compared to daily electrocardiograms (9.46% vs 4.44% p=0.0005), with a 2.24 fold risk increase of having atrial fibrillation in extra electrocardiograms.
Conclusions. Obtaining records with an electrocardiogram portable device is feasible and improves the identification of atrial fibrillation recurrences by a nurse team, with an extraordinary adherence of patients. The use of these type of devices allows the patient to obtain an electrocardiogram recording during symptoms, which improves diagnostic performance.

Versión en Español

Título:

Evaluación de la adherencia y la rentabilidad diagnóstica en detección de recurrencias tras ablación de fibrilación auricular mediante seguimiento con un dispositivo ECG portátil realizado por enfermería

Bibliography