scholarly journals On‐demand mobile health infrastructures to allow comprehensive remote atrial fibrillation and risk factor management through teleconsultation

2020 ◽  
Vol 43 (11) ◽  
pp. 1232-1239 ◽  
Author(s):  
Astrid N. L. Hermans ◽  
Rachel M. J. Velden ◽  
Monika Gawalko ◽  
Dominique V. M. Verhaert ◽  
Lien Desteghe ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Mobile Health ◽  
Risk Factor Management ◽  
On Demand

scholarly journals On-Demand Mobile Health Infrastructure for Remote Rhythm Monitoring within a Wait-and-See Strategy for Recent-Onset Atrial Fibrillation: TeleWAS-AF

Cardiology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Nikki A.H.A. Pluymaekers ◽  
Rachel M.J. van der Velden ◽  
Astrid N.L. Hermans ◽  
Monika Gawalko ◽  
Saskia Buskes ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Mobile Health ◽  
Treatment Decision ◽  
Care Process ◽  
Care Utilization ◽  
Recent Onset ◽  
On Demand ◽  
Wait And See ◽  
Rhythm Monitoring

Recently, we introduced the TeleCheck-AF approach, an on-demand mobile health (mHealth) infrastructure using app-based heart rate and rhythm monitoring for 7 days, to support long-term atrial fibrillation (AF) management through teleconsultation. Herein, we extend the mHealth approach to patients with recent-onset AF at the emergency department (ED). In the proposed TeleWAS-AF approach, on-demand heart rate and rhythm monitoring are used to support a wait-and-see strategy at the ED. All stable patients who present to the ED with recent-onset symptomatic AF and who are able to use mHealth solutions for heart rate and rhythm monitoring are eligible for this approach. Patients will receive both education on AF and instructions on the use of the mHealth technology before discharge from the ED. A case coordinator will subsequently check whether patients are able to activate the mHealth solution and to perform heart rate and rhythm measurements. Forty hours after AF onset, the first assessment teleconsultation with the physician will take place, determining the need for delayed cardioversion. After maximal 7 days of remote monitoring, a second assessment teleconsultation may occur, in which the rhythm can be reassessed and further treatment strategy can be discussed with the patients. This on-demand mHealth prescription increases patient involvement in the care process and treatment decision-making by encouraging self-management, while avoiding excess data-load requiring work-intensive and expensive data management. Implementation of the TeleWAS-AF approach may facilitate the management of AF in the ED and reduce the burden on the ED system, which enhances the capacity for health care utilization.

scholarly journals Quality indicators for the care and outcomes of adults with atrial fibrillation

EP Europace ◽  
2020 ◽  
Author(s):  
Elena Arbelo ◽  
Suleman Aktaa ◽  
Andreas Bollmann ◽  
André D’Avila ◽  
Inga Drossart ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Quality Indicators ◽  
Control Strategy ◽  
Rate Control ◽  
Rhythm Control ◽  
Patient Assessment ◽  
Risk Factor Management ◽  
Diagnosis And Management

Abstract Aims To develop quality indicators (QIs) that may be used to evaluate the quality of care and outcomes for adults with atrial fibrillation (AF). Methods and results We followed the ESC methodology for QI development. This methodology involved (i) the identification of the domains of AF care for the diagnosis and management of AF (by a group of experts including members of the ESC Clinical Practice Guidelines Task Force for AF); (ii) the construction of candidate QIs (including a systematic review of the literature); and (iii) the selection of the final set of QIs (using a modified Delphi method). Six domains of care for the diagnosis and management of AF were identified: (i) Patient assessment (baseline and follow-up), (ii) Anticoagulation therapy, (iii) Rate control strategy, (iv) Rhythm control strategy, (v) Risk factor management, and (vi) Outcomes measures, including patient-reported outcome measures (PROMs). In total, 17 main and 17 secondary QIs, which covered all six domains of care for the diagnosis and management of AF, were selected. The outcome domain included measures on the consequences and treatment of AF, as well as PROMs. Conclusion This document defines six domains of AF care (patient assessment, anticoagulation, rate control, rhythm control, risk factor management, and outcomes), and provides 17 main and 17 secondary QIs for the diagnosis and management of AF. It is anticipated that implementation of these QIs will improve the quality of AF care.

Risk Factor Management and Atrial Fibrillation Clinics: Saving the Best for Last?

2017 ◽  
Vol 26 (9) ◽  
pp. 990-997 ◽  
Author(s):  
Rajiv Mahajan ◽  
Rajeev K. Pathak ◽  
Anand Thiyagarajah ◽  
Dennis H. Lau ◽  
Francis E. Marchlinski ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Risk Factor Management

scholarly journals Cost-Effectiveness and Clinical Effectiveness of the Risk Factor Management Clinic in Atrial Fibrillation

2017 ◽  
Vol 3 (5) ◽  
pp. 436-447 ◽  
Author(s):  
Rajeev K. Pathak ◽  
Michelle Evans ◽  
Melissa E. Middeldorp ◽  
Rajiv Mahajan ◽  
Abhinav B. Mehta ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Cost Effectiveness ◽  
Clinical Effectiveness ◽  
Risk Factor Management

Risk Factor Management Before and After Atrial Fibrillation Ablation

2020 ◽  
Vol 12 (2) ◽  
pp. 141-154 ◽  
Author(s):  
Jonathan P. Ariyaratnam ◽  
Melissa Middeldorp ◽  
Gijo Thomas ◽  
Jean Jacques Noubiap ◽  
Dennis Lau ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Atrial Fibrillation Ablation ◽  
Risk Factor Management ◽  
Before And After

scholarly journals Gender differences and daily variation in atrial fibrillation risk factor profiles: Considerations for risk factor management

2019 ◽  
Vol 25 ◽  
pp. 100442
Author(s):  
Nikki A.H.A. Pluymaekers ◽  
Astrid N.L. Hermans ◽  
Melissa E. Middeldorp ◽  
Kadhim Kadhim ◽  
Harry J.G.M. Crijns ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Gender Differences ◽  
Risk Factor ◽  
Daily Variation ◽  
Risk Factor Management

P1211Does socioeconomic factors influence the outcomes of risk factor management and freedom of patients with atrial fibrillation

EP Europace ◽  
2018 ◽  
Vol 20 (suppl_1) ◽  
pp. i236-i237
Author(s):  
M E Middeldorp ◽  
A D Elliott ◽  
R K Pathak ◽  
A Gupta ◽  
C Gallagher ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Risk Factor ◽  
Socioeconomic Factors ◽  
Risk Factor Management

Coordination of a remote mHealth infrastructure for atrial fibrillation management during COVID-19 and beyond: TeleCheck-AF

2020 ◽  
Vol 23 (2-3) ◽  
pp. 65-70 ◽  
Author(s):  
Rachel MJ van der Velden ◽  
Astrid NL Hermans ◽  
Nikki AHA Pluymaekers ◽  
Monica Gawalko ◽  
Bianca Vorstermans ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Mobile Health ◽  
Multidisciplinary Team ◽  
Mhealth Intervention ◽  
On Demand ◽  
Outpatient Visits ◽  
Care Processes ◽  
Multiple Levels ◽  
Rhythm Monitoring

During the coronavirus 2019 (COVID-19) pandemic, outpatient visits for patients with atrial fibrillation (AF), were converted into teleconsultations. As a response to this, a novel mobile health (mHealth) intervention was developed to support these teleconsultations with AF patients: TeleCheck-AF. This approach incorporates three fundamental components: 1) “Tele”: A structured teleconsultation. 2) “Check”: An app-based on-demand heart rate and rhythm monitoring infrastructure. 3) “AF”: comprehensive AF management. This report highlights the significant importance of coordination of the TeleCheck-AF approach at multiple levels and underlines the importance of streamlining care processes provided by a multidisciplinary team, using an mHealth intervention, during the COVID-19 pandemic. Moreover, this report reflects on how the TeleCheck-AF approach has contributed to strengthening the health system in maintaining management of this prevalent sustained cardiac arrhythmia, whilst keeping patients out of hospital, during the pandemic and beyond.

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