Would it be worthwhile to monitor asymptomatic ablation patients suffering from heart failure more closely?
JP, a 60-year-old man in good health, began experiencing intermittent weakness during physical activities, such as walking uphill, in 2021. Months passed and the weakness gradually worsened, which led JP to finally seek medical attention. The doctor diagnosed a heart rhythm disorder, atrial fibrillation (AF), which can often be asymptomatic for the patient. Even asymptomatic AF is not harmless, as it can also lead to a stroke.
JP underwent electrical cardioversion in the first half of 2022. However, the procedure had to be repeated several times during 2022–2024, as the sinus rhythm always reverted to rapid AF. In the spring of 2024, a decision was made to switch to a drug regimen. This did not prevent the onset of rapid AF, but the patient’s heart went into failure. JP was hospitalized again due to his poor condition, and an ultrasound of the heart showed reduced contractile force.
In order to correct the recurrent arrhythmias and the resulting heart failure, the patient underwent cryoablation of AF in October 2024, in which the pulmonary veins are isolated by freezing the areas causing AF with a cryoballoon.
After returning home from the procedure, JP was given a PulseOn wrist device for monitoring arrhythmias, which he began wearing day and night. Eight days after the ablation, late at night, the device indicated that the rhythm had become irregular again. JP did not notice the changed rhythm himself, and he did not feel any sensations.
Often, after catheter ablation of AF, patients may experience AF, especially during the first 3-6 months. The outcome of the procedure is affected by, among other things, the size of the atrium, possible hypertension, untreated sleep apnea, obesity and, among other things, stress.
To prevent JP from falling into heart failure again, it is important to perform a rhythm conversion quickly. Without the monitoring device, his rhythm change would have gone unnoticed for a longer time. Only two days after the device detected AF, he underwent a new rhythm conversion in the hospital.
JP continued to monitor his heart rhythm using the wrist device, but luckily nothing showed up and life continued as normal. In January 2025, the device made a new detection, which led to a successful rhythm conversion a couple of days later. Since then, JP’s rhythm has finally remained good, for almost a year now.
JP: “I am very lucky to have access to this new device, because as far as I know, there is currently no continuous monitoring for ablation patients after treatment. As a medical device, using the bracelet has been very easy and unobtrusive. My life and strength have returned to a good level, I can walk again, even uphill.”
This case of JP raises the question of whether it would be worthwhile to monitor asymptomatic ablation patients suffering from heart failure more closely immediately after the operation. New technology offers an easy and cost-effective option for this.