Self-Reported Mobile Health-Based Risk Factor and CHA2DS2-VASc-Score Assessment in Patients With Atrial Fibrillation: TeleCheck-AF Results

Frontiers in Cardiovascular Medicine

Ron Pisters¹  Martin Hemels¹  Leonard Voorhout¹  Dhiraj Gupta²  Piotr Lodziński³  Bartosz Krzowski³  Monika Gawałko³  Nikola Kozhuharov⁴  Henri Gruwez⁶  Jeroen M. Hendriks⁸  Dominik Linz⁹  Afzal Sohaib^1,11  Rachel M. J. van der Velden^1,12  Astrid N. L. Hermans^1,12  Konstanze Betz^1,12  Nikki A. H. A. Pluymaekers^1,12  Kevin Vernooy^1,12  Dominique Verhaert^1,13  Daniel Scherr^1,14  Martin Manninger^1,14  Julia Meier^1,14  Daniel Steven^1,15  Elena Terentieva^1,15  Arian Sultan^1,15  David Duncker^1,16  Henrike A. K. Hillmann^1,16 

[1] 0Department of Cardiology, Rijnstate Hospital, Arnhem, Netherlands;1Liverpool Heart and Chest Hospital, Liverpool, United Kingdom;1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland;2Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland;3Department of Cardiology, Hospital East-Limburg, Genk, Belgium;4Department of Cardiovascular Sciences, University Hospitals Leuven, Leuven, Belgium;5Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia;6Center for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia;7Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;Barts Heart Center, St Bartholomew's Hospital, London, United Kingdom;Department of Cardiology, King George Hospital, Ilford, United Kingdom;Department of Cardiology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Maastricht, Netherlands;Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands;Department of Cardiology, University Clinic of Medicine, Medical University of Graz, Graz, Austria;Department of Electrophysiology, University of Cologne, Heart Center, Cologne, Germany;Hannover Heart Rhythm Center, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany;Institute of Pharmacology, West German Heart and Vascular Center, University Duisburg-Essen, Essen, Germany;

关键词: atrial fibrillation;    mobile health;    photoplethysmography;    risk factors;    thromboembolic risk;   

DOI  :  10.3389/fcvm.2021.757587

来源: DOAJ

【 摘 要 】

IntroductionThe TeleCheck-AF approach is an on-demand mobile health (mHealth) infrastructure incorporating mobile app-based heart rate and rhythm monitoring through teleconsultation. We evaluated feasibility and accuracy of self-reported mHealth-based AF risk factors and CHA2DS2-VASc-score in atrial fibrillation (AF) patients managed within this approach.Materials and MethodsConsecutive patients from eight international TeleCheck-AF centers were asked to complete an app-based 10-item questionnaire related to risk factors, associated conditions and CHA2DS2-VASc-score components. Patient's medical history was retrieved from electronic health records (EHR).ResultsAmong 994 patients, 954 (96%) patients (38% female, median age 65 years) completed the questionnaire and were included in this analysis. The accuracy of self-reported assessment was highest for pacemaker and anticoagulation treatment and lowest for heart failure and arrhythmias. Patients who knew that AF increases the stroke risk, more often had a 100% or ≥80% correlation between EHR- and app-based results compared to those who did not know (27 vs. 14% or 84 vs. 77%, P = 0.001). Thromboembolic events were more often reported in app (vs. EHR) in all countries, whereas higher self-reported hypertension and anticoagulant treatment were observed in Germany and heart failure in the Netherlands. If the app-based questionnaire alone was used for clinical decision-making on anticoagulation initiation, 26% of patients would have been undertreated and 6.1%—overtreated.ConclusionSelf-reported mHealth-based assessment of AF risk factors is feasible. It shows high accuracy of pacemaker and anticoagulation treatment, nevertheless, displays limited accuracy for some of the CHA2DS2-VASc-score components. Direct health care professional assessment of risk factors remains indispensable to ensure high quality clinical-decision making.

【 授权许可】

Unknown