eComment. Novel smartphone-dependent electrocardiographic patient monitoring after surgical atrial fibrillation ablation

Atrial fibrillation (AF) is an independent risk factor for death in patients undergoing cardiac surgery [1]. Atrial fibrillation surgery may improve survival. Charitos et al. reported results of patients undergoing concomitant surgical AF ablation during cardiac surgery. Detection of AF recurrence was done via implantable lead-less, continuous heart rhythm recorders (CM). All patients experienced some AF recurrence but patients who underwent surgical AF ablation with high-intensity focused ultrasound (HIFU) demonstrated a significantly higher need of cardioversion. They concluded that concomitant surgical AF ablation is an effective modality for the treatment of AF and continuous rhythm monitoring reveals short episodes of AF in the majority of patients during long-term follow-up. AliveCor heart monitor (AHM; AliveCor Inc, San Francisco, CA, USA) is a smartphone-dependent device that converts electrical signals gathered from finger tips into ultrasound signals. These signals then get transmitted to smartphone's microphone and an electrocardiographic (ECG) lead I is recorded. It is a promising technology, cheap and accurate. AliveCor follow-up has already been validated for post-AF catheter ablation and QT interval monitoring in patients on Dofetilide [2, 3].

In everyday practice, it is not possible to monitor every surgical AF ablation patient with implantable, continuous heart rhythm recorders (CM). But results of this study clearly show additional benefit of CM in these patients. We conclude that rhythm follow-up when the patient is symptomatic or with pre-set intervals may have clinical benefits. In the light of this study, patients who have undergone AF ablation with HIFU are especially appropriate for AliveCor follow-up.

Conflict of interest: none declared.

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