AFFU-AW study

trial fibrillation (AF) is the most common sustained arrhythmia in adults and presents a significant burden to patients, physicians, and healthcare systems globally. The heart rhythm disorder can cause debilitating symptoms, acute and chronic heart failure. Medical treatment options exist but catheter ablation (CA) is the most effective rhythm control strategy to restore normal sinus rhythm in symptomatic patients.

However, patients should be counselled that ablation is not a ‘one-stop’ cure and that recurrence of AF and AF symptoms is possible- and challenging to predict whom it will come back in. Despite technological advancements, AF can still recur in up to 50% of patients after the first procedure and so patients should know that a repeat procedure may be required for maximum benefit.

It is recommended that patients are followed up at 3-monthly intervals for the first year post-procedure and then on an annual basis thereafter to identify AF recurrences. If a patient reports symptoms compatible with a recurrence, they may be asked to do a 24-hour Holter monitor in hope of capturing the culprit rhythm. This pathway can take weeks-months to implement and the chances of capturing a symptomatic episode during the Holter monitor window can be quite low.

Studies using continuous heart rhythm monitors implanted under the skin have shown that the longer we monitor patients for, the more AF we detect- and faster too. So our primary research question is:

Can a prolonged, non-invasive heart rhythm monitoring strategy using the Apple Watch reduce the time to diagnosis of AF recurrence after catheter ablation compared to standard follow-up alone.

We're also measuring patient-reported outcomes, activity levels and overall freedom from AF at 12 months as well.

We're recruiting 172 patients having their first AF ablation at Barts Heart Centre. All will receive the full standard care and half will be randomised to receive an Apple Watch to monitor their heart rhythm for 12 months after their ablation.

If you're interested in finding out more, check out the patient information sheet in the tab at the top of the homepage or please email us at bartshealth.bartsaf@nhs.net