Digital monitoring and electronic patient-reported outcomes collection following atrial fibrillation ablation

Almeida, João G. ; Teixeira, Rafael ; Neves, Inês ; Carrington, Mafalda ; Fonseca, Paulo ; Oliveira, Marco ; Gonçalves, Helena ; Primo, João ; Fontes-Carvalho, Ricardo ; Barra, Sérgio ; Martínez, Juan Pablo (Universidad de Zaragoza) ; Almeida, Rute

Resumen: Background. Atrial fibrillation (AF) remains a challenging condition to manage traditionally in clinical practice, and despite improvements in digital health, its impact on clinical outcomes remains uncertain. Objective. This study aimed to assess the feasibility of a structured digital-blended follow-up for patients undergoing AF ablation, incorporating electronic patient-reported outcome measures (PROMs) while evaluating its impact on the timing of recurrence diagnosis and reintervention. Methods. In this retrospective observational study, we included patients enrolled in a structured 2-year digital program starting in January 2021. This featured a Web platform for physicians to record clinical variables and a patient-centered mobile application to report PROM (Atrial Fibrillation Effect on Quality-of-Life [AFEQT] and Patient-Reported Outcomes Measurement Information System [PROMIS]). Clinical outcomes were compared with those from a retrospective conventionally managed cohort (2017–2020) after propensity score matching (n = 363 per group). Results. Until May 2024, 421 patients were enrolled (mean age: 60.9 years; 33.0% female). Over a median follow-up of 546 days, 64% of the patients used the application monthly, and completeness rates for AFEQT and PROMIS questionnaires were 80% and 50%, respectively. At 12 months, significant improvements were observed for AFEQT and PROMIS scores (cognitive and physical function, anxiety, and depression). Arrhythmia recurrence significantly influenced the rates of changes for AFEQT, depression, and physical function (P < .05 for interactions). Digital follow-up was associated with a shorter time until atrial tachycardia or AF recurrence (hazard ratio 1.45, P = .019) and antiarrhythmic intervention (hazard ratio 1.65, P = .022). Conclusion. Systematic electronic PROM collection after AF ablation is feasible in clinical practice. Structured digital-blended integrated care guarantees continuity of AF management and supports earlier detection and treatment of recurrences

Idioma: Inglés

DOI: 10.1016/j.hroo.2025.04.004

Año: 2025

Publicado en: Heart Rhythm O2
ISSN: 2666-5018

Financiación: info:eu-repo/grantAgreement/ES/DGA/T39-23R
Financiación: info:eu-repo/grantAgreement/ES/MICINN/PID2022-140556OB-I00

Tipo y forma: Article (Published version)

Área (Departamento): Área Teoría Señal y Comunicac. (Dpto. Ingeniería Electrón.Com.)