The Lead Episode 48: A Discussion of Influence of Monitoring and Atrial Arrhythmia Burden on Quality of Life and Health Care Utilization in Patients Undergoing Pulsed Field Ablation: A Secondary Analysis of the PULSED AF Trial

Discussion Topic: Influence of Monitoring and Atrial Arrhythmia Burden on Quality of Life and Health Care Utilization in Patients Undergoing Pulsed Field Ablation: A Secondary Analysis of the PULSED AF Trial

Deepthy Varghese, MSN, ACNP, FNP, of Northside Hospital, is joined by Sammy Khatib, MD, Ochsner Clinic, Foundation Program, and William Whang, MD, FHRS, Mount Sinai Hospital, to discuss the PULSED AF study investigated the impact of monitoring strategies on atrial arrhythmia (AA) recurrence after pulsed field ablation (PFA) in atrial fibrillation (AF) patients. The study employed various monitoring approaches, including 24-hour Holter monitoring and symptomatic trans telephonic monitoring, revealing that freedom from all AAs varied significantly based on monitoring strategy. PFA demonstrated substantial efficacy, yielding zero burden in 69.4% of paroxysmal AF and 62.2% of persistent AF patients, with a median burden below 9%. Notably, patients with PAF and less than 10% AA burden experienced clinically meaningful quality of life (QoL) improvements, while persistent AF patients showed QoL enhancements regardless of burden. The study suggests that the choice of monitoring protocol influences the ≥30-second AA recurrence endpoint and highlights the association between low AA burden post-PFA, improved QoL, and reduced healthcare utilization related to AAs. Notably, higher AA burden correlated with increased instances of repeat ablations and cardioversions.

Host: Deepthy Varghese, MSN, ACNP, FNP
Guests: Sammy Khatib, MD and William Whang, MD, FHRS

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