Asymptomatic recurrences of atrial fibrillation (AF) have been found to be common after ablation.

A randomized controlled trial of AF screening using a handheld single-lead ECG monitor (BigThumb^®) or a traditional follow-up strategy was conducted in patients with non-valvular AF after catheter ablation. Consecutive patients were randomized to either BigThumb Group (BT Group) or Traditional Follow-up Group (TF Group). The ECGs collected via BigThumb were compared using the automated AF detection algorithm, artificial intelligence (AI) algorithm, and cardiologists' manual review. Subsequent changes in adherence to oral anticoagulation of patients were also recorded. In this study, we examined 218 patients (109 in each group). After a follow-up of 345.4 ± 60.2 days, AF-free survival rate was 64.2% in BT Group and 78.9% in TF Group (P = 0.0163), with more adherence to oral anticoagulation in BT Group (P = 0.0052). The participants in the BT Group recorded 26133 ECGs, among which 3299 (12.6%) were diagnosed as AF by cardiologists' manual review. The sensitivity and specificity of the AI algorithm were 94.4% and 98.5% respectively, which are significantly higher than the automated AF detection algorithm (90.7% and 96.2%).

As per our findings, it was determined that follow-up after AF ablation using BigThumb leads to a more frequent detection of AF recurrence and more adherence to oral anticoagulation. AI algorithm improves the accuracy of ECG diagnosis and has the potential to reduce the manual review.

已发现消融后无症状的房颤 (AF) 复发很常见。

在导管消融后的非瓣膜性 AF 患者中进行了一项使用手持式单导联心电监护仪 (BigThumb ^® ) 或传统随访策略进行AF 筛查的随机对照试验。连续患者被随机分配到 BigThumb 组（BT 组）或传统随访组（TF 组）。使用自动 AF 检测算法、人工智能 (AI) 算法和心脏病专家的人工审查比较通过 BigThumb 收集的心电图。还记录了患者对口服抗凝剂依从性的后续变化。在这项研究中，我们检查了 218 名患者（每组 109 名）。随访345.4±60.2天，BT组无AF生存率为64.2%，TF组为78.9%（P= 0.0163），BT 组对口服抗凝药的依从性更高（P = 0.0052）。BT 组参与者记录了 26133 次心电图，其中 3299 次（12.6%）经心脏病专家人工审核诊断为 AF。AI算法的灵敏度和特异性分别为94.4%和98.5%，明显高于自动AF检测算法（90.7%和96.2%）。

根据我们的研究结果，确定使用 BigThumb 进行 AF 消融后的随访会导致更频繁地检测到 AF 复发和更多地坚持口服抗凝治疗。AI算法提高了心电图诊断的准确性，并有可能减少人工审核。