Abstract
Background: Asymptomatic recurrences of atrial fibrillation (AF) are
common after ablation of AF. Objective: We aimed to analyze the
performance of the mobile ECG device using artificial intelligence (AI)
algorithm in detection of AF after ablation. Method: A randomized
controlled trial of AF screening using a handheld single-lead ECG
monitor (BigThumb®) or a traditional follow-up strategy was conducted in
patients with non-valvular AF after catheter ablation. Consecutive
patients were randomized to either BigThumb Group (BT Group) or
Traditional Follow-up Group (TF Group). Monitoring data was collected
and analyzed. The ECGs collected by BigThumb were compared using the
automated AF detection algorithm, AI algorithm and cardiologists’ manual
review. Subsequent changes in adherence on oral anticoagulation of
patients were also recorded. Result: We studied 218 patients (109 in BT
Group, 109 in TF Group). After a follow-up of 345.4±60.2 days, AF-free
survival rate was 64.2% in BT Group and 78.9% in TF Group (P=0.0163),
with more adherence on oral anticoagulation in BT Group (P=0.0052). The
participants in the BT Group recorded 26133 ECGs during the follow-up,
among which 3299 (12.6%) were diagnosed as AF by cardiologists’ manual
review. The sensitivity and specificity of the AI algorithm were 94.4%
and 98.5% respectively, which are significantly higher than the
automated AF detection algorithm (90.7% and 96.2%). Conclusion: We
found that follow-up after AF ablation using BigThumb leads to a more
frequent detection of AF recurrence and more adherence on oral
anticoagulation. Artificial intelligence algorithm improves the accuracy
of ECG diagnosis.