The Effect of Interventions for Atrial Arrhythmia on Physical Activity and Thoracic Impedance

Wright, Ian (2025) The Effect of Interventions for Atrial Arrhythmia on Physical Activity and Thoracic Impedance. Doctoral thesis (DClinSci), Manchester Metropolitan University.

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Abstract

Introduction Cardiac implantable electronic devices (CIEDs) store digital biomarkers (DBs). These have potential as surrogate outcome markers in research studies, and could enable more personalised treatment. We investigated the effect of clinically-indicated procedures for atrial arrhythmia (AA) on DBs. Method Exploratory single-site, retrospective, observational study. Procedures were either a catheter ablation (CA) or a direct current cardioversion (DCCV) for rhythm or rate control of AA. Device-measured physical activity (D-PA) and thoracic impedance (TI) measurements already stored as part of standard clinical care were retrieved. 24 months of data were analysed. For each patient, the 12 month period after the procedure (period B) was compared with the 12 months before (period A). For rhythm control patients, the change in AA burden (Δ AA), change in mean DPA (Δ DPA) and change in mean TI (Δ TI) were calculated. Δ D-PA and Δ TI were analysed for correlation with Δ AA. Patients were divided into tertiles according to the magnitude of Δ AA, and Δ D-PA and Δ TI compared between groups.