Arrhythmias & electrophysiologyResearch article
Smartphone Application–Derived Clusters of Persistent Symptoms in Patients After Atrial Fibrillation Ablation
- cluster analysis
- two-step cluster analysis
- smartphone app-based simultaneous symptom and photoplethysmography heart rhythm monitoring
Authors' conclusion
Half of all patients report symptoms after AF ablation. Using cluster analysis, 5 symptom-based AF subphenotypes were identified, each with distinct clinical characteristics, biomarker profiles, AF recurrence, AF pattern, AF and symptom burden, and symptom-rhythm correlation. Symptom clusters empowered by digital health may facilitate individualized AF management strategies following AF ablation.
Study context
- Population
- Patients at the 3-month follow-up after atrial fibrillation (AF) ablation313 of 614 [51%] reported symptoms, cluster analysis in symptomatic patients
- Participants
- 614 patients
- Comparison
- Symptom clusters compared on clinical characteristics and AF recurrence
- nonspecified symptomsn = 52
- AF with sparse symptomsn = 93
- palpitationsn = 47
- fatigue with comorbiditiesn = 63
- sinus rhythm with severe symptomsn = 58
Main finding
As reported in the abstract
Patients reporting symptoms
n = 313 of 614 [51%]
Further findings
| Outcome | Values |
|---|---|
| Symptom clusters identified · percentages of symptomatic patients | nonspecified symptoms 17% · AF with sparse symptoms 30% · palpitations 15% · fatigue with comorbidities 20% · sinus rhythm with severe symptoms 19% |
Symptom reporting, AF recurrence, AF load, AF pattern and symptom-rhythm correlation across clusters
- Frequency of symptom reporting differed between clusters
- P < 0.001
- Pattern of symptom reporting differed between clusters
- P < 0.001
- AF recurrence differed between clusters
- P < 0.001
- AF load differed between clusters
- P < 0.001
- AF pattern differed between clusters
- P = 0.002 and P = 0.005
- Symptom-rhythm correlation differed between clusters
- P < 0.001
Clinical characteristics across clusters
- Age differed between clusters
- P < 0.01
- N-terminal pro-B-type natriuretic peptide levels differed between clusters
- P < 0.01
- CHA2DS2-VA score differed between clusters
- P < 0.001
- Left atrial volume index differed between clusters
- P = 0.01
Original publication
Summarised from the published abstract; every number is checked against it