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, M Reijrink-De Boer St Antonius Hospital , Nieuwegein , Netherlands (The) Search for other works by this author on: Oxford Academic I Wolsink St Antonius Hospital , Nieuwegein , Netherlands (The) Search for other works by this author on: Oxford Academic I Frenaij Amsterdam UMC , Amsterdam , Netherlands (The) Search for other works by this author on: Oxford Academic K F Beukema St Antonius Hospital , Nieuwegein , Netherlands (The) Search for other works by this author on: Oxford Academic B Brouns St Antonius Hospital , Nieuwegein , Netherlands (The) Search for other works by this author on: Oxford Academic V F Van Dijk St Antonius Hospital , Nieuwegein , Netherlands (The) Search for other works by this author on: Oxford Academic M Liebregts St Antonius Hospital , Nieuwegein , Netherlands (The) Search for other works by this author on: Oxford Academic M C E F Wijffels St Antonius Hospital , Nieuwegein , Netherlands (The) Search for other works by this author on: Oxford Academic L V A Boersma St Antonius Hospital , Nieuwegein , Netherlands (The) Search for other works by this author on: Oxford Academic J C Balt St Antonius Hospital , Nieuwegein , Netherlands (The) Search for other works by this author on: Oxford Academic
Funding Acknowledgements: Type of funding sources: None.
Author Notes
EP Europace, Volume 26, Issue Supplement_1, May 2024, euae102.599, https://doi.org/10.1093/europace/euae102.599
Published:
24 May 2024
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M Reijrink-De Boer, I Wolsink, I Frenaij, K F Beukema, B Brouns, V F Van Dijk, M Liebregts, M C E F Wijffels, L V A Boersma, J C Balt, Initial experience with a virtual atrial fibrillation clinic after pulmonary vein isolation, EP Europace, Volume 26, Issue Supplement_1, May 2024, euae102.599, https://doi.org/10.1093/europace/euae102.599
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Abstract
Introduction
To detect recurrent atrial fibrillation (AF), a variety of methods are used, ranging from incidental electrocardiogram to rhythm monitoring with implantable loop recorders (ILRs). In clinical practice, routine use of ILRs is not feasible due to cost. Repeated (week)-Holters cause a considerable burden, both on patients and hospitals, and moreover are inadequate for detecting recurrent AF.
Purpose
To investigate whether remote monitoring (RM) is feasible in patients with AF after pulmonary vein isolation.
Methods
We set up a virtual AF clinic. Patients were equipped with a photopletysmography (PPG) application and asked to perform a recording when symptomatic. Recordings uploaded to the Hospital Electronic Patient Dossier and monitored by dedicated eNurses. The number of hospital contacts, hospital visits, electrocardiograms and Holter recordings were noted. Patient satisfaction and quality of life was measured by (validated) questionnaires. Comparisons were made with a historic control group from Jan-March 2019 with a traditional follow up of outpatient visits, electrocardiograms and Holters.
Results
157 patients were studied, 78 in the RM group and 79 in the control group. Mean age was 63 ± 10 years, 64% male. AF was paroxysmal in 68% of patients. Follow-up was 1 year and completed in all patients. In the RM group, patients performed 16±29 recordings/year. AF was detected in 37 (47%) patients on RM. While more planned remote contacts were performed in the RM group, significantly less planned and unplanned outpatient clinic visits, AF-related hospital admissions, and Holters took place. Patients report a high satisfaction with this form of remote monitoring.
Conclusions
A virtual AF clinic is feasible. When asked to record when symptomatic, patients perform few measurements. Compared to patients with a traditional follow-up, patients on PPG-based RM need fewer hospital visits and admissions, and undergo fewer Holters. Patient satisfaction with RM is high.
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Author notes
Funding Acknowledgements: Type of funding sources: None.
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
Topic:
- atrial fibrillation
- client satisfaction
- electrocardiogram
- ambulatory care facilities
- follow-up
- outpatients
- quality of life
- pulmonary vein ablation
- hospital admission
- telemonitoring
- rhythm
- implantable loop recorder
Issue Section:
e-Cardiology/digital health, public health, health economics, research methodology > e-Cardiology/Digital Health > Remote Patient Monitoring and Telehealth
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