Smartphone app-based approximation of time spent with atrial fibrillation and symptoms in patients after catheter ablation: Data from the TeleCheck-AF project.

AF burden AF symptoms atrial fibrillation catheter ablation mobile health photoplethysmography

Journal

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
ISSN: 1532-2092
Titre abrégé: Europace
Pays: England
ID NLM: 100883649

Informations de publication

Date de publication:
30 Sep 2024
Historique:
received: 25 07 2024
revised: 03 09 2024
accepted: 24 09 2024
medline: 30 9 2024
pubmed: 30 9 2024
entrez: 30 9 2024
Statut: aheadofprint

Résumé

Reduction of atrial fibrillation (AF) burden is the preferred outcome measure over categorical AF rhythm recurrence after AF ablation. In this sub-analysis of the TeleCheck-AF project we tested the feasibility of smartphone app-based approximation of time spent with AF and/or symptoms. Patients scheduled for at least one teleconsultation during the 12-month follow-up after AF ablation were instructed to use a smartphone photoplethysmography (PPG)-based application for simultaneous symptom and rhythm monitoring 3-times daily for 1 week. Proxies of time spent with AF and/or symptoms (%-recordings, load, %-days), temporal aggregation of AF and/or symptoms (density), and symptom-rhythm correlation (SRC) were assessed. In total 484 patients (60% male, 62±9.9 years) were included. Adherence, motivation and patient satisfaction were high. %AF-recordings, AF load and %AF-days (rs= 0.88-0.95) and %symptom-recordings, symptom load, %symptom-days (rs= 0.95-0.98) showed positive correlations. The SRC correlated negatively with time spent with symptoms (rs=-0.65--0.90) and with time spent with AF (rs=-0.31--0.34). In patients with paroxysmal AF before ablation and AF during the monitoring period, 87% (n=39/44) had a low-density score <50% ("paroxysmal AF pattern") while 5% (n=2/44) had a high-density score >90% ("persistent AF pattern"). Corresponding numbers for patients with persistent AF before ablation were 48% (n=11/23) and 43% (n=10/23), respectively. On-demand, app-based simultaneous rhythm and symptom assessment provides objective proxies of time spent with AF and/or symptoms and symptom-rhythm correlation, which may assist in assessing AF and symptom outcomes after AF ablation.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Reduction of atrial fibrillation (AF) burden is the preferred outcome measure over categorical AF rhythm recurrence after AF ablation. In this sub-analysis of the TeleCheck-AF project we tested the feasibility of smartphone app-based approximation of time spent with AF and/or symptoms.
METHODS METHODS
Patients scheduled for at least one teleconsultation during the 12-month follow-up after AF ablation were instructed to use a smartphone photoplethysmography (PPG)-based application for simultaneous symptom and rhythm monitoring 3-times daily for 1 week. Proxies of time spent with AF and/or symptoms (%-recordings, load, %-days), temporal aggregation of AF and/or symptoms (density), and symptom-rhythm correlation (SRC) were assessed.
RESULTS RESULTS
In total 484 patients (60% male, 62±9.9 years) were included. Adherence, motivation and patient satisfaction were high. %AF-recordings, AF load and %AF-days (rs= 0.88-0.95) and %symptom-recordings, symptom load, %symptom-days (rs= 0.95-0.98) showed positive correlations. The SRC correlated negatively with time spent with symptoms (rs=-0.65--0.90) and with time spent with AF (rs=-0.31--0.34). In patients with paroxysmal AF before ablation and AF during the monitoring period, 87% (n=39/44) had a low-density score <50% ("paroxysmal AF pattern") while 5% (n=2/44) had a high-density score >90% ("persistent AF pattern"). Corresponding numbers for patients with persistent AF before ablation were 48% (n=11/23) and 43% (n=10/23), respectively.
CONCLUSIONS CONCLUSIONS
On-demand, app-based simultaneous rhythm and symptom assessment provides objective proxies of time spent with AF and/or symptoms and symptom-rhythm correlation, which may assist in assessing AF and symptom outcomes after AF ablation.

Identifiants

pubmed: 39344253
pii: 7794090
doi: 10.1093/europace/euae247
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.

Auteurs

Emma Sandgren (E)

Department of Cardiology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Maastricht, Netherlands.
Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.

Astrid Nl Hermans (AN)

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

Monika Gawalko (M)

Department of Cardiology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Maastricht, Netherlands.
Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen, Essen, Germany.
1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Konstanze Betz (K)

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

Afzal Sohaib (A)

Barts Heart Center, St Bartholomew's Hospital, London, United Kingdom.
Department of Cardiology, King George Hospital, Ilford, United Kingdom.

Chi Ho Fung (CH)

Department of Cardiology, King George Hospital, Ilford, United Kingdom.

Henrike Ak Hillmann (HA)

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

Rachel Mj van der Velden (RM)

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

Dominique Verhaert (D)

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

Daniel Scherr (D)

Department of Cardiology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Maastricht, Netherlands.
Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

Arian Sultan (A)

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

Daniel Steven (D)

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

Ron Pisters (R)

Department of Cardiology, Rijnstate Hospital, Arnhem, Netherlands.

Martin Hemels (M)

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

Piotr Lodziński (P)

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Sevasti-Maria Chaldoupi (SM)

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

Dhiraj Gupta (D)

Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.

Henri Gruwez (H)

Department of Cardiology, Hospital East-Limburg, Genk, Belgium.
Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium.

Nikki Aha Pluymaekers (NA)

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

Jeroen M Hendriks (JM)

Caring Futures Institute, College of Nursing and Health Sciences,Flinders University, Adelaide, SA, Australia.
Center for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia.

Malene Nørregaard (M)

Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Martin Manninger (M)

Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

David Duncker (D)

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

Dominik Linz (D)

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

Classifications MeSH