On-demand mobile health infrastructures to allow comprehensive remote atrial fibrillation and risk factor management through teleconsultation.


Journal

Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272

Informations de publication

Date de publication:
Nov 2020
Historique:
received: 23 08 2020
revised: 15 09 2020
accepted: 17 09 2020
pubmed: 9 10 2020
medline: 20 11 2020
entrez: 8 10 2020
Statut: ppublish

Résumé

Although novel teleconsultation solutions can deliver remote situations that are relatively similar to face-to-face interaction, remote assessment of heart rate and rhythm as well as risk factors remains challenging in patients with atrial fibrillation (AF). Mobile health (mHealth) solutions can support remote AF management. Herein, we discuss available mHealth tools and strategies on how to incorporate the remote assessment of heart rate, rhythm and risk factors to allow comprehensive AF management through teleconsultation. Particularly, in the light of the coronavirus disease 2019 (COVID-19) pandemic, there is decreased capacity to see patients in the outpatient clinic and mHealth has become an important component of many AF outpatient clinics. Several validated mHealth solutions are available for remote heart rate and rhythm monitoring as well as for risk factor assessment. mHealth technologies can be used for (semi-)continuous longitudinal monitoring or for short-term on-demand monitoring, dependent on the respective requirements and clinical scenarios. As a possible solution to improve remote AF care through teleconsultation, we introduce the on-demand TeleCheck-AF mHealth approach that allows remote app-based assessment of heart rate and rhythm around teleconsultations, which has been developed and implemented during the COVID-19 pandemic in Europe. Large scale international mHealth projects, such as TeleCheck-AF, will provide insight into the additional value and potential limitations of mHealth strategies to remotely manage AF patients. Such mHealth infrastructures may be well suited within an integrated AF-clinic, which may require redesign of practice and reform of health care systems.

Sections du résumé

BACKGROUND BACKGROUND
Although novel teleconsultation solutions can deliver remote situations that are relatively similar to face-to-face interaction, remote assessment of heart rate and rhythm as well as risk factors remains challenging in patients with atrial fibrillation (AF).
HYPOTHESIS OBJECTIVE
Mobile health (mHealth) solutions can support remote AF management.
METHODS METHODS
Herein, we discuss available mHealth tools and strategies on how to incorporate the remote assessment of heart rate, rhythm and risk factors to allow comprehensive AF management through teleconsultation.
RESULTS RESULTS
Particularly, in the light of the coronavirus disease 2019 (COVID-19) pandemic, there is decreased capacity to see patients in the outpatient clinic and mHealth has become an important component of many AF outpatient clinics. Several validated mHealth solutions are available for remote heart rate and rhythm monitoring as well as for risk factor assessment. mHealth technologies can be used for (semi-)continuous longitudinal monitoring or for short-term on-demand monitoring, dependent on the respective requirements and clinical scenarios. As a possible solution to improve remote AF care through teleconsultation, we introduce the on-demand TeleCheck-AF mHealth approach that allows remote app-based assessment of heart rate and rhythm around teleconsultations, which has been developed and implemented during the COVID-19 pandemic in Europe.
CONCLUSION CONCLUSIONS
Large scale international mHealth projects, such as TeleCheck-AF, will provide insight into the additional value and potential limitations of mHealth strategies to remotely manage AF patients. Such mHealth infrastructures may be well suited within an integrated AF-clinic, which may require redesign of practice and reform of health care systems.

Identifiants

pubmed: 33030259
doi: 10.1002/clc.23469
pmc: PMC7661648
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1232-1239

Informations de copyright

© 2020 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.

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Auteurs

Monika Gawalko (M)

Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands.

Dominique V M Verhaert (DVM)

Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands.
Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.

Lien Desteghe (L)

Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
Heart Center Hasselt, Jessa Hospital, Hasselt, Belgium.
Department of Cardiology, Antwerp University Hospital and Antwerp University, Antwerp, Belgium.

David Duncker (D)

Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.

Martin Manninger (M)

Department of Cardiology, Medizinische Universität Graz, Graz, Austria.

Hein Heidbuchel (H)

Department of Cardiology, Antwerp University Hospital and Antwerp University, Antwerp, Belgium.

Ron Pisters (R)

Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands.

Martin Hemels (M)

Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands.

Laurent Pison (L)

Department of Cardiology, Hospital East Limburg, Genk, Belgium.

Afzal Sohaib (A)

Department of Cardiology, St Bartholomew's Hospital, Bart's Health NHS Trust, London, UK.
Department of Cardiology, King George Hospital, London, UK.

Arian Sultan (A)

Department of Electrophysiology, Heart Center, University Hospital Cologne, Cologne, Germany.

Daniel Steven (D)

Department of Electrophysiology, Heart Center, University Hospital Cologne, Cologne, Germany.

Petra Wijtvliet (P)

Department of Cardiology, Martini Hospital, Groningen, The Netherlands.

Robert Tieleman (R)

Department of Cardiology, Martini Hospital, Groningen, The Netherlands.

Dhiraj Gupta (D)

Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK.

Dobromir Dobrev (D)

Institute of Pharmacology, West German Heart and Vascular Centre, University Duisburg-Essen, Essen, Germany.

Emma Svennberg (E)

Department of Clinical Sciences, Division of Cardiovascular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.

Harry J G M Crijns (HJGM)

Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands.

Nikki A H A Pluymaekers (NAHA)

Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands.

Jeroen M Hendriks (JM)

Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.

Dominik Linz (D)

Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands.
Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

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