Abstract
BackgroundPersonal digital devices may offer insights into patient recovery and an approach for remote monitoring after procedures.ObjectiveTo examine associations between activity measured using personal digital devices, patient-reported outcome measures (PROMs), and clinical events among patients after catheter ablation for atrial fibrillation (AF) or bariatric surgery.MethodsWe aggregated personal digital device, PROM, and electronic health record data in a study conducted at 2 health systems. We used Fitbit devices for step count assessments, KardiaMobile for cardiac rhythm assessments, and PROMs for pain and palpitations over 5 weeks.ResultsAmong 59 patients, 30 underwent AF ablation and 29 bariatric surgery. Thirty-six patients (63%) reported pain. There was no difference in median [interquartile range] daily steps between patients with and those without pain (4419 [3286–7041] vs 3498 [2609–5888]; P = .23). Among AF ablation patients, 21 (70%) reported palpitations. Median daily steps were lower among those with palpitations than among those without (4668 [3021–6116] vs 8040 [6853–10,394]; P = .03). When accounting for within-subject correlation, recordings of AF were associated with a significant mean decrease in median daily steps (–351; 95% confidence interval –524 to –177; P <.01). Patients who received a new antiarrhythmic drug prescription had AF recorded in a median of 5 [5–5] of 5 total weeks, whereas patients who did not receive a new antiarrhythmic recorded AF in a median of 1 [0–3] week (P = .02).ConclusionPersonal digital device and PROM data can provide insight into postprocedural recovery outside of usual clinical settings and may inform follow-up and clinical decision-making. (ClinicalTrials.gov Identifier: NCT03436082)
Highlights
Personal digital devices, such as Apple WatchÒ (Apple Inc, Cupertino, CA), FitbitÒ (Fitbit, Inc, San Francisco, CA), digital blood pressure cuffs, and mobile electrocardiographic (ECG) devices, represent novel data sources that can offer insight into patient experiences outside of clinical settings
We recently demonstrated the feasibility of prospectively aggregating real-world data from multiple sources, including personal digital device, patient-reported outcome measure (PROM), electronic health record (EHR), and pharmacy data, as part of a cohort study of 60 patients undergoing catheterbased atrial fibrillation (AF) ablation or bariatric surgery.[21]
This study demonstrates that personal digital device data and PROMs can inform our understanding of postprocedural patient recovery after AF ablation and bariatric surgery
Summary
CA), represent novel data sources that can offer insight into patient experiences outside of clinical settings. These devices have been used to characterize physical activity after specific procedures, such as cardiac and orthopedic surgery.[1,2,3] Lower step counts have been associated with postsurgical. 2666-6936/Published by Elsevier Inc. on behalf of Heart Rhythm Society. Personal digital devices may offer insights into patient recovery and an approach for remote monitoring after procedures
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