First real-world experience with mobile health telemonitoring in adult patients with congenital heart disease.

M A C Koole,B J M Mulder,D Kauw,M P Schijven,M M Winter,M J Schuuring,D A J Dohmen,B J Bouma,I I Tulevski,R De Haan,G A Somsen,D Robbers-Visser

doi:10.1007/s12471-018-1201-6

Abstract

BackgroundArrhythmias and heart failure are common and invalidating sequelae in adult patients with congenital heart disease (CHD). Mobile health (m-Health) enables daily monitoring and a timely response that might prevent deterioration. We present an observational prospective registry to evaluate feasibility of an m‑Health telemonitoring program for managing arrhythmia, heart failure and blood pressure in symptomatic adults with CHD.MethodsSymptomatic adult patients with CHD are enrolled in an m‑Health telemonitoring program, which evaluates single-lead ECG, blood pressure and weight measurements. In case of symptoms extra measurements could be performed. Data are collected by mobile apps, matched with individualised thresholds. Patients are contacted if thresholds were exceeded or if arrhythmias were found, for treatment adjustments or reassurance. Data on emergency care utilisation, hospitalisation and patient-reported outcome measures are used to assess quality of life and self-management.Results129 symptomatic CHD patients were invited to participate, 55 participated. Reasons for refusing consent included too time consuming to participate in research (30) and to monitor vital signs (14). At baseline 22 patients were in New York Heart Association class ≥ II heart failure, 43 patients had palpitations or documented arrhythmias, and 8 had hypertension. Mean follow-up was 3.0 months, one patient dropped out, and adherence was 97%.ConclusionThe first results indicate that this program is feasible with high adherence.

Highlights

Telemonitoring is available and could be a powerful tool for diagnosing and treating arrhythmia and heart failure
Symptomatic adult patients with congenital heart disease (CHD) are enrolled in an m-Health telemonitoring program, which evaluates single-lead ECG, blood pressure and weight measurements
It can be useful for adjusting antihypertensive medication in order to reach optimal blood pressure in real-life circumstances

Summary

Introduction

Telemonitoring is available and could be a powerful tool for diagnosing and treating arrhythmia and heart failure It can be useful for adjusting antihypertensive medication in order to reach optimal blood pressure in real-life circumstances. This may be especially true for adult patients with congenital heart disease (CHD). They are a growing patient population [1, 2]. Contemporary care is organised by several outpatient visits per year These visits are needed to optimise dosing of medication and detect complications or disease progression [3,4,5,6,7].

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Conclusion