The Importance of Arrhythmia Burden for Outcomes and Management Related to Catheter Ablation of Atrial Fibrillation

Atrial fibrillation (AF) ablation has been shown to be an effective treatment for AF, although our understanding of AF ablation outcomes until now, has been based on AF recurrence as a dichotomous variable. Reduction in AF burden, defined as the proportion of time that an individual is in AF during a monitoring period, has been already correlated to an improvement in quality of life and is likely a better assessment of success. Clinically, many patients may still have a few short recurrences of AF but feel much better. In addition, several studies have related higher AF burden with poorer health outcomes and a higher risk of stroke. Despite the growing understanding of AF burden, it is not clear yet which threshold of AF burden would be considered an appropriate outcome measure for AF ablation. Further investigations are needed to address that question. However, the reduction of AF burden seems to be a more accurate reflection of procedural success and a better predictor of prognosis and stroke risk than a single measure of AF.