Continuous ECG monitoring enhances detection of AF after cardiac surgery: JAMA

The intervention group underwent continuous cardiac rhythm monitoring with wearable, patch-based monitors for 30 days after randomization. Monitoring was not mandated in the usual care group within 30 days after randomization.

The primary outcome was cumulative AF and/or atrial flutter lasting 6 minutes or longer detected by continuous cardiac rhythm monitoring or by a 12-lead electrocardiogram within 30 days of randomization.

The results of the study are as follows:

• Of the 336 patients were randomized, 307 completed the trial.
• In the intent-to-treat analysis, the primary endpoint occurred in 32 patients in the intervention group vs 3 patients in the usual care group.
• AF lasting 6 hours or longer was detected in 14 patients in the intervention group vs 0 patients in the usual care group.

Thus, the researchers concluded that in post-cardiac surgical patients at high risk of stroke, no preoperative AF history, and AF lasting less than 24 hours during hospitalization, continuous monitoring revealed a significant increase in the rate of POAF after discharge that would otherwise not be detected by usual care. Studies are needed to examine whether these patients will benefit from oral anticoagulation therapy.

Reference:

Effect of Continuous Electrocardiogram Monitoring on Detection of Undiagnosed Atrial Fibrillation After Hospitalization for Cardiac Surgery: A Randomized Clinical Trial by Ha A et. al published in the JAMA Netw. Open.

doi:10.1001/jamanetworkopen.2021.21867