OBJECTIVES: An ICM is a programmable monitoring system that stores a patient’s subcutaneous ECG and other diagnostic information. Its features are aimed at detecting arrhythmias and their long term trending. Since long-term continuous AF monitoring is not yet used in patients with PAAF in Spain, its implications in the management of these patients (including possible OAC discontinuation) are still unknown. This study aimed to model the cost-effectiveness of OAC management using ICMs in patients treated with radiofrequency catheter ablation for atrial fibrillation (PAAF) in Spain. METHODS: A Markov model was built to simulate the outcomes and costs of Standard of Care (SOC, traditional intermittent 24H monitors) and continuous AF monitoring with an ICM (Reveal XT). Efficacy data was obtained from clinical studies showing that Reveal was able to detect asymptomatic episodes in AF patients, thus facilitating an optimized disease management that may reduce long-term complications incidence. The risks of stroke, adverse events management and utility figures where taken from international literature; local Spanish costs where used to model the economic consequences of PAAF for three years. Costs and effects were discounted at 3%. RESULTS: Model results show that the continuous long-term AF monitoring with ICMs may be associated to a gain of 0.16 at an extra cost of €6100, showing an iCER of €37,994 per QALY gained. Sensitivity analysis showed an important uncertainty regarding the effectiveness of ICMs, with a 95% CI of QALY gains of 0.11-0.21.CONCLUSIONS: The preliminary results of this study show that ICMs may improve PAAF outcomes but extra healthcare costs are to be considered. Longer follow-up analyses and inclusion of eventual quality of life gains associated to the reduction of uncertainty of patients regarding their disease, may improve the economic value of this novel strategy using AF monitoring systems.