Telemedicine for diagnosing and managing paroxysmal atrial fibrillation in outpatients. The phone in the pocket

Shacham, Jacob; Birati, Edo Y.; Malov, Nomi; Yanay, Yigal; Steinberg, David M.; Tamari, Mira; Golovner, Michal; Roth, Arie

doi:10.1016/j.ijcard.2010.12.014

Cited by 14 publications

(4 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previously, the use of telemedicine for rapid out-of-hospital diagnosis and the provision of objective instructions has been assessed as an alternative management pathway for patients with a history of paroxysmal AF. 20 Results of this study demonstrated that almost 80% of paroxysmal AF episodes were managed successfully out of hospital, avoiding the need for unnecessary hospitalisations or clinic visits.…”

Section: Discussionmentioning

confidence: 81%

Canada-wide mixed methods analysis evaluating the reasons for inappropriate emergency department presentation in patients with a history of atrial fibrillation: the multicentre AF-ED trial

Hong¹,

Babiolakis

Zile

et al. 2020

BMJ Open

View full text Add to dashboard Cite

ObjectivesThe primary objective of this study was to ascertain the reasons for emergency department (ED) attendance among patients with a history of atrial fibrillation (AF).DesignAppropriate ED attendance was defined by the requirement for an electrical or chemical cardioversion and/or an attendance resulting in hospitalisation or administration of intravenous medications for ventricular rate control. Quantitative and qualitative responses were recorded and analysed using descriptive statistics and content analysis, respectively. Random effects logistic regression was performed to estimate the OR of inappropriate ED attendance based on clinically relevant patient characteristics.ParticipantsParticipants ≥18 years with a documented history of AF were approached in one of eight centres partaking in the study across Canada (Ontario, Nova Scotia, Alberta and British Columbia).ResultsOf the 356 patients enrolled (67±13, 45% female), the majority (271/356, 76%) had inappropriate reasons for presentation and did not require urgent ED treatment. Approximately 50% of patients(172/356, 48%) were driven to the ED due to symptoms, while the remainder presented on the basis of general fear or anxiety (67/356, 19%) or prior medical advice (117/356, 33%). Random effects logistic regression analysis showed that patients with a history of congestive heart failure were significantly more likely to seek urgent care for appropriate reasons (p=0.03). Likewise, symptom-related concerns for ED presentation were significantly less likely to result in inappropriate visitation (p=0.02). When patients were surveyed on alternatives to ED care, the highest proportion of responses among both groups was in favour of specialised rapid assessment outpatient clinics (186/356, 52%). Qualitative content analysis confirmed these results.ConclusionsImproved education focused on symptom management and alleviating disease-related anxiety as well as the institution of rapid access arrhythmias clinics may reduce the need for unnecessary healthcare utilisation in the ED and subsequent hospitalisation.Trial registration numberNCT03127085

show abstract

Section: Discussionmentioning

confidence: 81%

Canada-wide mixed methods analysis evaluating the reasons for inappropriate emergency department presentation in patients with a history of atrial fibrillation: the multicentre AF-ED trial

Hong¹,

Babiolakis

Zile

et al. 2020

BMJ Open

View full text Add to dashboard Cite

show abstract

“… 9 Subcutaneous devices have been increasing in popularity, but these are invasive and may result in procedural complications. 12 …”

Section: Discussionmentioning

confidence: 99%

Remote Management of Atrial Fibrillation: A Case Report

Chiu¹,

Kasper²,

Rimmer³

et al. 2017

CPCEM

View full text Add to dashboard Cite

We report a case of new-onset atrial fibrillation with rapid ventricular response in a 37-year-old male who presented to the emergency department. This patient was not admitted to the hospital or placed on observation, but rather placed on a cellular outpatient 12-lead telemetry (COTLT) device with emergency response capabilities and discharged home. We define a new modality that allows these patients to be managed via telemedicine and receive care similar to that which would be rendered in a hospital or observation unit.

show abstract

“…11 Furthermore, in patients with paroxysmal atrial fibrillation (AF), mHealth provided rapid remote diagnosis of recurrences of AF through a telephone-transmitted EKG recorded at home, enabling rapid management of the episode and even preventing hospital visits. 17 Thus, mHealth already demonstrated benefits for several cardiac patient groups. However, healthcare professionals are still hesitant to adopt mHealth in daily practice, which is also shown by the utilisation rate of telemonitoring that has remained unchanged over the past years in the Netherlands.…”

Section: Introductionmentioning

confidence: 99%

Mobile health in cardiac patients: an overview on experiences and challenges of stakeholders involved in daily use and development

et al. 2020

View full text Add to dashboard Cite

BackgroundMobile health (mHealth) can improve quality of care and empower cardiac patients. However, large-scale adoption is still lacking, as several challenges continue to be encountered in daily practice. We aimed to explore the mHealth experiences and challenges in cardiac patients, healthcare professionals, healthcare managers and information and communications technology (ICT) developers.MethodsA qualitative research was employed where semistructured interviews were conducted in patients, healthcare professionals, managers and ICT developers. We aimed to enrol participants of every stakeholder group, with diversity in sex, age group and occupation. Thematic analysis was used to identify themes reflecting experiences and challenges in mHealth in cardiac patients.ResultsIn total, 24 interviews were conducted in six patients, eight healthcare professionals, five managers and five ICT developers. Monitoring/care at home was reported as important advantage of mHealth (n=20, 83%). Patients valued increase of self-care (n=6, 100%) and remote reassurance (n=6, 100%), but reported medicalisation as important concern (n=4, 67%). Healthcare professionals warned for increased data burden (n=4, 50%). Managers agreed on the importance of device reliability (n=5, 100%) and ICT developers emphasised that the goal of mHealth is to replace care, rather than being supplementary (n=4, 80%). The majority of all participants (n=22, 92%) considered future use of mHealth as promising.ConclusionsAll stakeholders foresee benefit of mHealth in cardiac patients, especially for remote care and reassurance. Frequently mentioned challenges included the need to replace care with mHealth, rather than adding more workload, and employing reliable devices and applications. If collaboration can be improved and group-specific challenges overcome, success of mHealth in cardiac patients can improve significantly.

show abstract

Telemedicine for diagnosing and managing paroxysmal atrial fibrillation in outpatients. The phone in the pocket

Cited by 14 publications

References 26 publications

Canada-wide mixed methods analysis evaluating the reasons for inappropriate emergency department presentation in patients with a history of atrial fibrillation: the multicentre AF-ED trial

Canada-wide mixed methods analysis evaluating the reasons for inappropriate emergency department presentation in patients with a history of atrial fibrillation: the multicentre AF-ED trial

Remote Management of Atrial Fibrillation: A Case Report

Mobile health in cardiac patients: an overview on experiences and challenges of stakeholders involved in daily use and development

Contact Info

Product

Resources

About