B-AB05-04 TELEMEDICINE ATRIAL FIBRILLATION CARE: AN INTEGRATIVE REVIEW

Abstract

Atrial Fibrillation is a global phenomenon associated with an embolic stroke risk, decreased functional capacity, and worsening quality of life. An episode of atrial fibrillation can be highly symptomatic for patients and many rely on the emergency department for care even though it is often not a genuine medical emergency. Increasing patient access to specialty atrial fibrillation specialists via telemedicine has the potential to improve patient care. To determine what is known about telemedicine atrial fibrillation programs. After input from advance practice registered nurses and cardiac electrophysiologists, a search strategy was developed. The guiding research question, inclusion and exclusion criteria, and proposed research terms were agreed upon. Next, a comprehensive literature search was applied to PubMed and CINAHL. Key terms were “Atrial Fibrillation AND Telemedicine or Telehealth NOT Mobile and NOT Detection”. The Johns Hopkins Evidence Based Practice Appraisal tool was used independently by three researchers to appraise each publication. Fifty-seven records were identified through the database search. After removing two duplicates, 55 were screened. Forty-eight records were excluded - 22 for wrong disease and 26 for wrong setting. Seven full-text articles were assessed for eligibility. Four full-text articles were excluded - two for non-peer review and two for wrong setting. Three studies were included for review - two qualitative and one quantitative. Three themes emerged from the literature: 1) atrial fibrillation requires specialty care that is difficult to obtain; 2) comprehensive atrial fibrillation education should address a broad condition overview, management options, stroke prevention, and symptom management; and 3) telemedicine is effective for diagnosing and managing atrial fibrillation. An atrial fibrillation telemedicine clinic is an emerging area of clinical importance because of the need for timely patient care to decrease referral wait times to cardiac electrophysiology, reduce unnecessary emergency department visits, reduce stroke risk, and increase guideline adherence.