A recent randomized trial results published in JAMA revealed that continuous ECG monitoring of post-op cardiac surgery patients at a high risk of stroke and no preoperative AF showed a significant increase in the rate of Post operative atrial fibrillation (PAOF) that would otherwise have not been detected by usual care. Here are a few key pointers from the study:

  1. Adult patients with no prior history of AF pre-op, AF or Atrial Flutter (AFL) lasting less than 24 hours during hospitalization after surgery and those with elevated risk of stroke were among those meeting inclusion criteria. Those with a history of AF or AFL lasting greater than 24 hours during hospitalization after surgery were among those meeting exclusion criteria.
  2. The monitoring group comprised of those receiving continuous 30-day ECG monitoring, the usual care group comprised of those with no mandated monitoring. A total of 336 patients were assigned randomly 1:1 to both the groups.
  3. Patients randomized to the monitoring group received up to 30 days of continuous ECG
    monitoring with a wearable, adhesive patch monitor. The primary outcome was cumulative AF and/or atrial flutter lasting 6 minutes or longer detected by continuous cardiac rhythm monitoring or by a 12-lead electrocardiogram within 30 days of randomization.
  4. Among those who completed the trial AF and/or AFL lasting 6 minutes or longer occurred in 32 patients (19.6%) in the intervention group vs 3 patients (1.7%) in the usual care group.

Conclusion: The authors concluded that among the aforementioned group of post cardiac surgical patients continuous ECG monitoring revealed a significant increase in the rate of POAF after discharge that would otherwise not be detected by usual care.