A virtual platform to deliver ambulatory care for patients with atrial fibrillation

Abstract

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Insights from a single centre implementation of a digitally-enabled atrial fibrillation virtual ward

“…A consistent theme from received feedback was that the provision of remote monitoring enabled patients to feel safer in their own homes, better supported and more empowered to manage their health. We did encounter a small number of patients with an aversion or anxiety towards digital technologies, which is in keeping with feedback from similar AF virtual ward models [ 11 , 19 ].…”

An Evaluation of Device-Measured Physical Activity Levels of Patients With Nonpermanent Atrial Fibrillation

“…Approval was obtained from the Research Ethics Board at the QEII Health Sciences Centre, Halifax, Nova Scotia (protocol #: 1022225). This was a pre-specified secondary analysis of a larger study 5. In brief, patients (≥18 yr of age), referred for specialist evaluation for new-onset nonvalvular AF or under specialist care with symptomatic AF, were able to ambulate independently and provided written informed consent to participate.…”

Atrial fibrillation: epidemiology, screening and digital health

“… 67 Germany RCT Daily transmission of body weight, BP, heart rate/rhythm, oxygen saturation, and self-rated health status 282 (IC) 289 (UC) 74 ± 8.0 74 ± 8.1 32% 30% 12 months Days lost due to unplanned CV death or hospitalization (IC vs UC): OR 0.60, 95% CI 0.25–0.95 All-cause mortality: HR 0.60, CI 0.36–1.00 Unpowered results Specific-region setting New-diagnosed AF not considered in the analyses Weng et al. 68 PC Kinduct AF Online educational and treatment platform 93 63 ± 12 42% 6 months Patient QoL (baseline vs FU): improved (OR 0.45, 95% CI 0.28–0.71) based on CCS-AF; NS changes based on AFSS, EQ-5D Patient satisfaction: user friendly (83% of patients), easy to navigate (85%), good source for AF information (73%) Underpowered results Log in with credentials may have deterred users RCT Heart rhythm tracker (KardiaMobile) 36 (IC) 71 (UC) 61 61 33% 40% 6 months AFSS score (IC vs UC): mean difference 2.52, 95% CI −4.48 to −0.25 ED visits, hospitalization: NS No data on frequency of AHM use Low usage rate Lazaridis et al. 69 Usability myAlgos Physician oriented platform, patient oriented mobile app 5 (physician) 33 (patient) 57 ± 36 37% 4 weeks Physicians rating: PSSUQ score of 2.5 ± 0.4; mean satisfaction 75% Patients rating: MAUQ score of 79.9%; arrangement of the app's interface: 56 ± 8.1 out of 70 (80%); app's predicted usefulness in the self-management of AF: 45 ± 6.3 out of 56 (81.5%) Small sample size RCT ...…”

“…A total of 33 publications were considered relevant. Of those, 14 publications reported on integrated e-health enhanced management of AF, 47 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 5 on remote AF management platforms, 65 , 66 , 67 , 68 , 69 3 publications on mHealth-based heart rate/rhythm monitoring, 70 , 71 , 72 6 publications on mHealth supported patient self-care and medication adherence tools 73 , 74 , 75 , 76 , 77 , 78 and 5 publications reported on clinical decision making support tools. 79 , 80 , 81 , 82 , 83 …”