{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T11:46:20Z","timestamp":1782906380479,"version":"3.54.5"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Symptom severity in atrial fibrillation (AF) influences healthcare use, but conventional assessments lack temporal precision. We evaluated the feasibility of smartphone-based symptom severity assessment after AF catheter ablation and explored predictors and variability of symptom severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In this analysis of the ISOLATION study, 140 patients used a photoplethysmography-supported smartphone application to record heart rhythm, symptoms, and symptom severity three times daily and when symptomatic for 7 days at 3, 6, and 12 months after ablation. Symptom severity was classified using the modified European Heart Rhythm Association scale. A total of 8575 recordings were analysed, of which 11% showed AF. Median adherence was 67%. Symptom severity was higher during AF, in women, and with higher heart rate. Nearly half of AF recordings were asymptomatic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Smartphone-based symptom severity assessment after AF ablation is feasible and reveals substantial individual variability beyond rhythm status alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euag139","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T11:00:25Z","timestamp":1781521225000},"source":"Crossref","is-referenced-by-count":0,"title":["Symptom severity assessment in patients with atrial fibrillation after catheter ablation using a smartphone application"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7410-3246","authenticated-orcid":false,"given":"Emma","family":"Sandgren","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]},{"name":"Karolinska Institutet, Department of Clinical Sciences, Danderyd University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3943-3896","authenticated-orcid":false,"given":"Konstanze","family":"Betz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]},{"name":"Department of Internal Medicine, Eifelklinik St.Brigida GmbH & Co. KG , Kammerbruchstra\u00dfe 8, Simmerath 52152 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4619-9062","authenticated-orcid":false,"given":"Monika","family":"Gawalko","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]},{"name":"1st Department of Cardiology, Doctoral School, Medical University of Warsaw , \u017bwirki i Wigury 61, Warsaw 02-091 ,","place":["Poland"]},{"name":"Institute of Pharmacology, West German Heart and Vascular Centre, University Duisburg-Essen , Forsthausweg 2, Duisburg 47057 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9034-1479","authenticated-orcid":false,"given":"Astrid","family":"Hermans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0369-7670","authenticated-orcid":false,"given":"Zarina","family":"Habibi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3477-2589","authenticated-orcid":false,"given":"Dominique","family":"Verhaert","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]},{"name":"Department of Cardiology, Radboud University Medical Center and Radboud Institute for Health Sciences , Geert Grooteplein Zuid 10, Nijmegen 6525 GA ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Philippens","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0982-2858","authenticated-orcid":false,"given":"Bianca","family":"Vorstermans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandy","family":"Kessels","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2355-8539","authenticated-orcid":false,"given":"David","family":"Bovenkerk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7780-4427","authenticated-orcid":false,"given":"Ben J M","family":"Hermans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4326-9256","authenticated-orcid":false,"given":"Jeroen M","family":"Hendriks","sequence":"additional","affiliation":[{"name":"Department of Nursing, Maastricht University Medical Centre , Maastricht ,","place":["The Netherlands"]},{"name":"Department of Health Services Research, Care and Public Health Research Institute, Maastricht University , Maastricht ,","place":["The Netherlands"]},{"name":"Centre for Heart Rhythm Disorders, Royal Adelaide Hospital, The University of Adelaide , 1 Port Road, Adelaide, SA 5000 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4158-0545","authenticated-orcid":false,"given":"Dennis","family":"den Uijl","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3938-6193","authenticated-orcid":false,"given":"Sevasti-Maria","family":"Chaldoupi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9598-2286","authenticated-orcid":false,"given":"Justin","family":"Luermans","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo","family":"Lankveld","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1532-3315","authenticated-orcid":false,"given":"Ulrich","family":"Schotten","sequence":"additional","affiliation":[{"name":"Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University , Maastricht ,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8818-5964","authenticated-orcid":false,"given":"Kevin","family":"Vernooy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4893-0824","authenticated-orcid":false,"given":"Dominik","family":"Linz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre , P.Debyelaan 25, Maastricht 6229 HX ,","place":["the Netherlands"]},{"name":"Centre for Heart Rhythm Disorders, Royal Adelaide Hospital, The University of Adelaide , 1 Port Road, Adelaide, SA 5000 ,","place":["Australia"]},{"name":"Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , N\u00f8rregade 10, Copenhagen 1165 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"2026063016321021500_euag139-B1","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/j.ahj.2014.02.003","article-title":"Drivers of hospitalization for patients with atrial fibrillation: results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF)","volume":"167","author":"Steinberg","year":"2014","journal-title":"Am Heart J"},{"key":"2026063016321021500_euag139-B2","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1093\/europace\/eut395","article-title":"The European Heart Rhythm Association symptom classification for atrial fibrillation: validation and improvement through a simple modification","volume":"16","author":"Wynn","year":"2014","journal-title":"Europace"},{"key":"2026063016321021500_euag139-B3","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euae247","article-title":"Smartphone app-based approximation of time spent with atrial fibrillation and symptoms in patients after catheter ablation: data from the TeleCheck-AF project","volume":"26","author":"Sandgren","year":"2024","journal-title":"Europace"},{"key":"2026063016321021500_euag139-B4","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1161\/CIRCRESAHA.119.316342","article-title":"Emerging technologies for identifying atrial fibrillation","volume":"127","author":"Ding","year":"2020","journal-title":"Circ Res"},{"key":"2026063016321021500_euag139-B5","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1001\/jamacardio.2016.0529","article-title":"Differences in clinical and functional outcomes of atrial fibrillation in women and men: two-year results from the ORBIT-AF Registry","volume":"1","author":"Piccini","year":"2016","journal-title":"JAMA Cardiol"},{"key":"2026063016321021500_euag139-B6","article-title":"Atrial fibrillation: better symptom control with rate and rhythm management","volume":"37","author":"Gupta","year":"2024","journal-title":"Lancet Reg Health Eur"},{"key":"2026063016321021500_euag139-B7","article-title":"Role of biological sex in normal cardiac function and in its disease outcome\u2014a review","volume":"8","author":"Prabhavathi","year":"2014","journal-title":"J Clin Diagn Res"},{"key":"2026063016321021500_euag139-B8","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.mpmed.2010.03.014","article-title":"Physiology of the normal heart","volume":"38","author":"Wilcken","year":"2010","journal-title":"Medicine (Baltimore)"},{"key":"2026063016321021500_euag139-B9","doi-asserted-by":"crossref","first-page":"2933","DOI":"10.1161\/CIRCULATIONAHA.111.069450","article-title":"Symptoms and 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