TOPLINE:

Patients with atrial fibrillation (AF) given an Apple Watch for ECG monitoring after first-time catheter ablation had earlier and more frequent detection of AF recurrence and fewer unplanned hospitalizations than those receiving standard care, according to a brief report published in JACC.

METHODOLOGY:

• Researchers conducted a prospective randomized controlled trial to assess whether smartwatch-based ECG monitoring performed by patients after first-time catheter ablation improved the detection of AF recurrence and influenced the use of healthcare.
• They included 168 patients who underwent first-time catheter ablation for paroxysmal or persistent AF at a London-based tertiary center and had access to an iPhone running the latest iOS. The mean age of the patients was 60.5 years, and 31% were women.
• Patients were randomly assigned to either an active monitoring group or a standard care group. Patients in the active group received an Apple Watch Series 5 and were instructed to record daily single-lead ECGs, with additional recordings during symptoms or device alerts, and to transmit ECGs to the research team.
• The standard care group received usual follow-up, including clinic visits at 3, 6, and 12 months, ECGs in clinic, and symptom-guided Holter monitoring.
• The primary outcome was time to first AF recurrence documented by ECG after a 90-day blanking period. Secondary outcomes included freedom from AF at 12 months, unplanned hospitalizations, and referrals for repeat ablation; total follow-up duration was 12 months.

TAKEAWAY:

• Patients in the active-monitoring group vs standard-care group had AF recurrences more often (52.9% vs 34.9%; P = .028), with earlier detection of first recurrence (median time to detection, 116 vs 132 days; P = .010), driven mainly by paroxysmal AF (32.9% vs 15.7%; P = .015).
• Patients in the active-monitoring group vs standard-care group had fewer unplanned hospitalizations (22 vs 47 events; P = .023) and were overall less likely to be hospitalized (incidence rate ratio, 0.46; P = .009).
• Patients in the active monitoring group recorded a median of 170 smartwatch ECGs over 12 months; those with AF recurrence sent more ECGs than those without (median, 12 vs 1; P < .001).
• Rates of repeat catheter ablation within 12 months were similar in both groups.

IN PRACTICE:

“Findings may support the integration of patient-owned wearable devices into structured postablation follow-up pathways,” the researchers wrote.

SOURCE:

The study was led by Nikhil Ahluwalia, MBBS, PhD, of St Bartholomew’s Hospital in London, England. It was published online on January 28 as a brief report in JACC.

LIMITATIONS: 

The open-label design of the study may have contributed to higher AF detection in the active group. Brief AF episodes may have been missed because ECG recordings were initiated by patients.

DISCLOSURES:

The study received research grants from Barts Charity and Abbott Inc. Apple, Inc., provided the Apple Watch devices. Two authors reported receiving grants and/or speaker fees, being inventors and/or shareholders of, and having other financial ties with various healthcare, biotechnology, and medical devices companies including Abbott, Medtronic, and Epicardio, Ltd. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.