Digital patient care program following successful ablation or cardioversion of patients with atrial fibrillation

Abstract

Abstract Background The current ESC guidelines on atrial fibrillation recommend the assessment of disease burden and the rigorous management of cardiovascular risk factors. A digital patient care program (Digital Health Program Atrial Fibrillation) was offered to patients following pulmonary vein isolation or cardioversion in cooperation with a major German statutory health insurer and a leading cardiology clinic. The 12 month program consists of the following functions: (1) self-recording of 1-channel-ECGs by patients with the possibility to receive short-term assessment by a teledoctor; (2) Patient education on health literacy, management of risk factors and lifestyle optimization via an App; (3) Monitoring of blood pressure and body weight; (4) Medication management via the App; und (5) videoconsultations on demand. When needed, medication was optimized by the teledoctors, or patients were referred to their family practice or cardiologists. Results an interim analysis of 72 patients that have participated in the first 6 months of the program showed: 1.) Over 20,000 ECGs were written, or a mean of approx. 1.5 ECGs/patient/day. Based on the teledoctor assessment of the ECGs and the videoconsultation over the platform recurring atrial fibrillation could be detected early and with high reliability, and patients could be advised. 2.) Figure A.: In patients with known, but insufficiently controlled arterial blood pressure at baseline (systolic blood pressure > 130 mmHg), blood pressure was reduced by 7.2 ±7.8 mmHg (mean ± std); n = 20. 3.) Figure B.: In obese patients at baseline (BMI ≥ 30) the body weight was reduced by 3.03 ±4.71 KG (mean ± std); n = 26. Summary: The combination self-recorded ECGs with high adherence, the feedback by the App and the possibility to book a short-term teledoctor appointment made it possible to perform quick and reliable assessment and give concrete recommendations to the patient. Furthermore, the accompanying education program led to reduced blood pressure and body weight. This systematic analysis of a real world digital patient care program indicates that the program is feasible and effective. These results need to be confirmed in a controlled study.Figure 1