Introduction
Surgical and catheter ablation of atrial fibrillation (AF) have emerged as a safe1 and effective alternative to antiarrhythmic drug therapy2–4,5,67,8,9,10. The perceived success rate of these procedures is highly dependent on the duration of AF recurrence that defines treatment failure as well as the intensity and duration of monitoring11–14. Historically, clinical trials have used varying cutoffs of AF recurrence with varying methods to detect the endpoint. Society guidelines define AF recurrence as any AF, atrial tachycardia (AT) or atrial flutter (AFL) of at least 30 seconds after a 90-day blanking period15, a definition that has traditionally been tested with intermittent ECGs and Holter monitors performed at fixed intervals or with symptoms. With the rapid expansion of direct to consumer monitoring technologies, the ease of patient reported self-monitoring of AF recurrences post-intervention has already started to shift the paradigm towards a more patient- facing approach.