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Post-ablation outcome monitoring using a pulse-deriving smartphone application

Session Digital health in clinical practice

Speaker Tine Proesmans

Event : ESC Congress 2018

  • Topic : e-cardiology / digital health, public health, health economics, research methodology
  • Sub-topic : m-Health
  • Session type : Rapid Fire Abstracts

Authors : T Proesmans (Diepenbeek,BE), T Vanhecke (Gent,BE), B Francois (Genk,BE), M Rivero-Ayerza (Genk,BE), H Van Herendael (Genk,BE), D De Cock (Ypres,BE), D Nuyens (Genk,BE), F Provenier (Gent,BE), T Boussy (Groeninge,BE)

Authors:
T. Proesmans1 , T. Vanhecke2 , B. Francois3 , M. Rivero-Ayerza3 , H. Van Herendael3 , D. De Cock4 , D. Nuyens3 , F. Provenier2 , T. Boussy5 , 1Hasselt University, Mobile Health Unit - Diepenbeek - Belgium , 2Maria Middelares, Department of Cardiology - Gent - Belgium , 3Hospital Oost-Limburg (ZOL), Department of Cardiology - Genk - Belgium , 4Jan Yperman Hospital, Department of Cardiology - Ypres - Belgium , 5AZ Groeninge, Department of Cardiology - Groeninge - Belgium ,

Citation:
European Heart Journal ( 2018 ) 39 ( Supplement ), 226

Objectives: Despite improvements of outcome of ablation for AF, early arrhythmia recurrence is not uncommon up to 3 months post-ablation. Although these arrhythmias are transient and do not represent treatment failure, it is widely recognized as a risk factor for long-term recurrence. To date, a better understanding in the correlation between early and long-term recurrence is hindered by an inability to continuously monitor these patients. We hypothesize that the implementation of a pulse-deriving smartphone application in this population offers the potential to detect early as well as late recurrence in order to initiate proper treatment in a timely manner.

Methods: Four clinical centres included a total of 80 participants who underwent successful AF treatment using ablation therapy. All participants were instructed to measure twice daily with a pulse-deriving smartphone application and additionally when experiencing symptoms, for a monitoring period of 4 months post-ablation. The planned usual-care pathway was registered at study inclusion. All measurements were revised algorithmically and confirmed by the treating physicians and healthcare professionals from a monitoring centre. At time of inclusion and study end a 12-lead ECG was performed.

Results: The mean age of the study population was 66 (±13) years from which 25% was male. Using the CHA2DS2-VASc score, 61% of the participants had an increased stroke risk (i.e. a score of 2 or more). Overall compliance to conduct measurements was recorded at 91% with 2 measurements per day. The smartphone app was able to identify 29 AF-cases (36%) of which 27 paroxysmal and 2 persistent. Only 37% of the AF cases were symptomatic. In the usual care path only 3/29 (10%) cases were identified with 12-lead ECG at the next scheduled consult and 9 (31%) patients identified with AF would been monitored by Holter.

Conclusion: Pulse-deriving smartphone applications implemented in combination with a structured care path proved to be a promising methodology for short- and long-term outcome monitoring of post-ablation patients and are capable in the detection of silent intermittent atrial fibrillation episodes.

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