Digital Health Program Following Rhythm Control in Patients with Atrial Fibrillation: Comprehensive Disease Management by Self-Monitoring, Coaching and Telemedicine
Georges von Degenfeld, Anke Langbein, Alessandra Boscheri, Maximilian O Ziegler, Jonas Demlehner, Paul Weyh, Alexander Leber, Sandra Schreier, Stefan G SpitzerAbstract
Background
Digital health is becoming increasingly powerful and available but is frequently not effec vely integrated into daily prac ce. A hybrid program was developed to provide holis c diagnos c and therapeu c patient care in atrial fibrillation.
Methods
Patients (n = 68) were recruited at the Electrophysiology Center following successful interven onal restora on of sinus rhythm. The 12 month program consists of the key modali es: (1) self-recording of 1-lead-ECGs, (2) short-term remote ECG diagnosis and medical advice by videoconsulta on, and (3) App-based educa on on lifestyle and risk factor op miza on with videoconsulta on.
Results
Patients recorded 29,092 ECGs, averaging 1.42 ECGs/day. Recurrent arrhythmia was found and confirmed in 39 patients. In all cases, arrhythmia was first diagnosed based on wearable ECG over the pla orm, rather than by standard in-office ECG/Holter. No false posi ve occurred. Patients with recurred arrhythmia were treated by pulmonary vein isola on (n =17), electric cardioversion (n =17), an arrhythmic medica on (n =5) or other interven onal procedures (n =1). Most patients (n =30) scheduled a videoconsulta on over the App as the first medical touchpoint a er arrhythmia occurrence. In 21 patients with arterial hypertension, systolic blood pressure was reduced by 8.0 ±8.6 mmHg (mean ±std), p<0.01. In 25 patients with obesity (BMI ≥30), body weight was reduced by 3.6 ±5.5 KG (mean ±std), p<0.01.
Conclusion
This real-world analysis indicates that the hybrid holis c program is applicable in daily prac ce, is ac vely followed by patients and improves diagnos c and therapeu c outcomes. These promising data need to be confirmed in a controlled randomized study.