Watch Your AF! - Trial

Aim: The Apple Watch for AF detection in patients with an implanted loops recorder after catheter ablation.

O. Göing, J. Brachmann, W. Haverkamp, A. Schirdewan

AF in Germany

  • App. 2.000.000 affected patients, > 50.000 patients undergo atrial fribrillation ablation annually.
  • Decision to continue long-term anticoagulation is based on stroke risk scores (CHA2DS2-VASc-Score) irrespective of the results of cather ablation.
  • Many patients receive anticoagulation after ablation although they do not have AF (→ increased bleeding risk).
  • New techniques for non-invasive long-term heart rhythm monitoring are urgently needed.

AF in Germany

  • Trial design
    • Prospective observational study in 100 consecutive patients undergoung implantation of loop recorder (IRL) after catheter ablation of AF.
    • Daily transmission of ECGs recorderd by the ILR and by an Apple-Watch (observation period: 6 months). Additional recordings triggerd by the patient.
    • Blinded evaluation of all tracings by a core lab.
    • Assessment of the diagnostic accuracy of Apple Watch recordings (in comparison to the IRL) with determination of individual AF burden.

AF in Germany

  • Advantages of the Apple-Watch over IRL
    • Non-invasive technique (IRL: easy implantation but potentially troublesome explantation, no data regarding repeated device implantation).
    • Life-long monitorning becomes feasible (IRL: battery life app. 3 years).
    • Can be used used when needed – monitoring can be stopped when needed (IRL: 50% of all AF recurrenecss after ablation are deteced within 3 months after the blanking period – the device usually remains vor 3 years)

Apple Watch: symptomatic and asymptomatic AF episodes

  • AF detection
    • The ECG app creates, records, stores, transfers, and displays a single channel ECG in order to determine the presence of AF or sinus rhythm.
    • The irregular rhythm notification feature continuously analyzes pulse rate data to identify episodes of irregular heart rhythms suggestive of AF and provides a notification to the user (→ detenction of asymptomatic AF episodes).

Apple Watch: symptomatic and asymptomatic AF episodes