Long-term follow-up case study of atrial fibrillation after treatment

A case study is presented, based on long-term ECG measurements of a patient with diagnosed persistent atrial fibrillation (PeAF) that undergone the classical diagnostic procedures. The long-term measurements have been performed with an ECG body sensor. Based on the European Heart Rhythm Association (EHRA) guidelines for treatment of atrial fibrillation the left atrial catheter cryo-ablation with an endpoint of pulmonary vein isolation was performed. After the cryo-ablation PeAF still persists, therefore an additional catheter radiofrequency ablation was performed. After the second procedure and in combination with antiarrhythmic drugs the atrial fibrillation (AF) was controlled on the level of relatively rare and short documented AF episodes. A detailed analysis of a long-term measurement has enabled detection of a large spectrum of arrhythmias, which have been documented over a ten-week period of measurements. Those include atrial extrabeats and nonsustained atrial tachycardias that might be the initial triggers for AF. The initial study motivates new hypotheses about the long-term impact of ablation procedures and antiarrhythmic drugs on the outcome of medical therapies, which deserves to be further elucidated with a larger and more systematic study.