NCT05016791Completed
Apple Watch-led Surveillance of AF Recurrence After Catheter Ablation
Evaluating the Impact of Prolonged, Patient-led Heart Rhythm Surveillance With the Apple Watch on Detecting Arrhythmia Recurrence and Decision-making After Catheter Ablation of Atrial Fibrillation
Source: ClinicalTrials.gov · Last updated 4 Mar 2025
Brief summary (registry, in English)
Atrial fibrillation (AF) is a heart rhythm disorder associated with debillitating symptoms, psychological distress and heart failure. It can also significantly increase an individuals stroke risk. Catheter ablation (CA) for AF is the most effective way to restore normal heart rhythm. However, AF can recur in up to 50% of patients after their first CA procedure and a second 'top-up' procedure may be needed to maximise effect. Early detection of recurrences can enable planning and treatment and repeat CA procedures. Post-CA follow-up strategies rely on episodic rhythm monitoring (Holter monitor tests) that usually last between 1 and 7 days. However, AF recurrences can be intermittent and may not occur during these short monitoring episodes. A greater duration of monitoring has been shown to yield greater detection of AF recurrences. Relying on symptoms alone to detect recurrence is also sub-optimal. AF recurrences can also be insidious. Similar symptoms may be reported from ectopy, atrial tachycardias or atrial flutter. These may require different management approaches, necessitating rhythm characterisation before considering a repeat CA. The Apple Watch (AW) is a wristwatch that is able to monitor a wearer's heart rate and rhythm regularity as well as facilitating an immediate, real-time single-lead ECG recording. This non-invasive device that can be purchased over- the-counter has demonstrated feasibility in detecting AF and may offer a potential non-invasive, alternative long-term rhythm surveillance strategy to diagnose AF in these patients. The investigators propose a single-centre, randomised controlled study to compare the standard follow-up strategy after index AF CA versus one supplemented with an AW-led prolonged monitoring strategy to determine if the latter will improve the expediency and rate of AF recurrence detection. Whether this will lead to improved downstream decision-making, reduction in symptomatic events and a lower prevalence of AF in the longer term will also be studied.
- Status (registry)
- Completed
- Study type
- Interventional
- Enrollment
- 172 (actual)
- First submitted
- 16 Jul 2021
- Start date
- 26 Jan 2022
- Primary completion date
- 30 Aug 2024
- Lead sponsor
- Barts & The London NHS Trust
- Diseases
- Atrial fibrillation
- NCT number
- NCT05016791
What you commit to
- Study type: Interventional
- Participants enrolled: 172
- From 26 Jan 2022 to the primary completion date, 30 Aug 2024
- 1 site in 1 country
- Visits and tests: ask the trial team, the registry does not list them
Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.
Who cannot take part
Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.
Prior treatment
- Previous left atrial (LA) ablation or LA surgery
- Cardiac surgery, angioplasty, or cerebrovascular accident within 4 weeks prior to enrolment.
Other illness
- Any cardiac implantable electronic device in situ or expected to undergo implantation in the next 12 months.
- Acute coronary syndrome within 4 weeks as defined by ECG ST segment depression or prominent T-wave inversion and/or positive biomarkers of necrosis (e.g. troponin) in the absence of ST-segment elevation and in an appropriate clinical setting (chest discomfort or angina equivalent).
Other
- Patients with permanent AF. Permanent AF is defined as chronic, persisting AF (typically more than 1 year) for which cardioversion (pharmacologic or electrical) has failed or will never be attempted.
- Patients with AF felt to be secondary to an obvious reversible cause.
- Patients who are, or may potentially be pregnant.
- Pre-existing pulmonary vein stenosis or PV stent
- Pre-existing hemi-diaphragmatic paralysis
- Contraindication to anticoagulation or radiocontrast materials
- Life expectancy less than 1 year
Who the study is looking for
- Referred for first AFCA procedure by a Consultant electrophysiologist.
- Paroxysmal or persistent AF captured on ECG but not in continuous AF for more than 3 years. (Paroxysmal AF is defined as an episode of AF that terminates spontaneously or with intervention within 7 days of onset. Persistent AF will be defined as any continuous episode lasting longer than 7 days or requiring intervention to restore sinus rhythm after this time.)
- At least one episode of AF must have been documented by ECG or Holter within 12 months of inclusion in the study.
- Continuous anticoagulation with warfarin (INR 2-3), low molecular weight heparin, or a novel oral anticoagulant (dabigatran, apixaban, rivaroxaban, edoxaban) for ≥4 weeks prior to the ablation; or a TEE that excludes LA thrombus ≤48 hours before ablation.
- Access to a smartphone with Apple-operating system (OS) within their household for syncing with their watch.
- Participants must be able and willing to provide written informed consent
Age in the registry: 21 years to - · Sex: All · Does not accept healthy volunteers
Sites (1)
Sites in registry order. Pick your city on the disease page to sort them by distance.
| Site | City | Country | Site status |
|---|---|---|---|
| St Bartholomew's Hospital Coordinator of this site? Confirm its status | City of London | United Kingdom | Unknown status |
This page is information, not medical advice. Discuss any trial with your doctor.