TY - JOUR
T1 - Mobile health adherence for the detection of recurrent recent-onset atrial fibrillation
AU - van der Velden, Rachel M. J.
AU - Pluymaekers, Nikki A. H. A.
AU - Dudink, Elton A. M. P.
AU - Luermans, Justin G. L. M.
AU - Meeder, Joan G.
AU - Heesen, Wilfred F.
AU - Lenderink, Timo
AU - Widdershoven, Jos W. M. G.
AU - Bucx, Jeroen J. J.
AU - Rienstra, Michiel
AU - Kamp, Otto
AU - van Opstal, Jurren M.
AU - Kirchhof, Charles J. H. J.
AU - van Dijk, Vincent F.
AU - Swart, Henk P.
AU - Alings, Marco
AU - van Gelder, Isabelle C.
AU - Crijns, Harry J. G. M.
AU - Linz, Dominik
N1 - Funding Information: JL has a consultancy agreement with Medtronic and has received speakers fee from Bayer and Novartis, and a research grant ZonMW LEAP trial project number 852002101. MR has received consultancy fees from Medtronic, Arca Biopharma and Roche to the institution, unrestricted research grant from ZonMW and the Dutch Heart Foundation; DECISION project 848090001. Unrestricted research grants from the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation; RACE V (CVON2014-9), RED-CVD (CVON2017-11). Unrestricted research grant from Top Sector Life Sciences & Health to the Dutch Heart Foundation (PPP Allowance; CVON-AI (2018B017)). Unrestricted research grant from the European Union’s Horizon 2020 research and innovation programme under grant agreement; EHRA-PATHS (945260). IVG has received consultancy fees Institute from Medtronic, Daiichi, BMS, Bayer and Roche to the institution, unrestricted research grants from the Netherlands Cardiovascular Research Initiative: an initiative with support of the Dutch Heart Foundation; unrestricted research grant from the European Union’s Horizon 2020 research and innovation programme under grant agreement; EHRA-PATHS (945260). Funding Information: The present substudy was not funded. The RACE 7 ACWAS trial was supported by a grant (837002524) from the Netherlands Organization for Health Research and Development–Health Care Efficiency Research Programme and by the Maastricht University Medical Center. Boehringer Ingelheim provided some of the remote monitoring devices. Publisher Copyright: ©
PY - 2022/8/29
Y1 - 2022/8/29
N2 - Objective: The Rate Control versus Electrical Cardioversion Trial 7-Acute Cardioversion versus Wait and See trial compared early to delayed cardioversion for patients with recent-onset symptomatic atrial fibrillation (AF). This study aims to evaluate the adherence to a 4-week mobile health (mHealth) prescription to detect AF recurrences after an emergency department visit. Methods: After the emergency department visit, the 437 included patients, irrespective of randomisation arm (early or delayed cardioversion), were asked to record heart rate and rhythm for 1 min three times daily and in case of symptoms by an electrocardiography-based handheld device for 4 weeks (if available). Adherence was appraised as number of performed measurements per number of recordings asked from the patient and was evaluated for longitudinal adherence consistency. All patients who used the handheld device were included in this subanalysis. Results: 335 patients (58% males; median age 67 (IQR 11) years) were included. The median overall adherence of all patients was 83.3% (IQR 29.9%). The median number of monitoring days was 27 out of 27 (IQR 5), whereas the median number of full monitoring days was 16 out of 27 (IQR 14). Higher age and a previous paroxysm of AF were identified as multivariable adjusted factors associated with adherence. Conclusions: In this randomised trial, a 4-week mHealth prescription to monitor for AF recurrences after an emergency department visit for recent-onset AF was feasible with 85.7% of patients consistently using the device with at least one measurement per day. Older patients were more adherent. Trial registration number: NCT02248753.
AB - Objective: The Rate Control versus Electrical Cardioversion Trial 7-Acute Cardioversion versus Wait and See trial compared early to delayed cardioversion for patients with recent-onset symptomatic atrial fibrillation (AF). This study aims to evaluate the adherence to a 4-week mobile health (mHealth) prescription to detect AF recurrences after an emergency department visit. Methods: After the emergency department visit, the 437 included patients, irrespective of randomisation arm (early or delayed cardioversion), were asked to record heart rate and rhythm for 1 min three times daily and in case of symptoms by an electrocardiography-based handheld device for 4 weeks (if available). Adherence was appraised as number of performed measurements per number of recordings asked from the patient and was evaluated for longitudinal adherence consistency. All patients who used the handheld device were included in this subanalysis. Results: 335 patients (58% males; median age 67 (IQR 11) years) were included. The median overall adherence of all patients was 83.3% (IQR 29.9%). The median number of monitoring days was 27 out of 27 (IQR 5), whereas the median number of full monitoring days was 16 out of 27 (IQR 14). Higher age and a previous paroxysm of AF were identified as multivariable adjusted factors associated with adherence. Conclusions: In this randomised trial, a 4-week mHealth prescription to monitor for AF recurrences after an emergency department visit for recent-onset AF was feasible with 85.7% of patients consistently using the device with at least one measurement per day. Older patients were more adherent. Trial registration number: NCT02248753.
KW - atrial fibrillation
UR - http://www.scopus.com/inward/record.url?scp=85137810317&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/heartjnl-2022-321346
DO - https://doi.org/10.1136/heartjnl-2022-321346
M3 - Article
C2 - 36322782
SN - 1355-6037
VL - 109
SP - 26
EP - 33
JO - Heart
JF - Heart
IS - 1
M1 - heartjnl-2022-321346
ER -