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

Abstract

Background: Although novel teleconsultation solutions can deliver remote situations that are relatively similar to face-to-face interaction, remote assessment of heart rate and rhythm as well as risk factors remains challenging in patients with atrial fibrillation (AF). Hypothesis. Mobile health (mHealth) solutions can support remote AF management. Methods: Herein, we discuss available mHealth tools and strategies on how to incorporate the remote assessment of heart rate, rhythm and risk factors to allow comprehensive AF management through teleconsultation. Results: Particularly, in the light of the coronavirus disease 2019 (COVID-19) pandemic, there is decreased capacity to see patients in the outpatient clinic and mHealth has become an important component of many AF outpatient clinics. Several validated mHealth solutions are available for remote heart rate and rhythm monitoring as well as for risk factor assessment. mHealth technologies can be used for (semi-)continuous longitudinal monitoring or for short-term on-demand monitoring, dependent on the respective requirements and clinical scenarios. As a possible solution to improve remote AF care through teleconsultation, we introduce the on-demand TeleCheck-AF mHealth approach that allows remote app-based assessment of heart rate and rhythm around teleconsultations, which has been developed and implemented during the COVID-19 pandemic in Europe. Conclusion: Large scale international mHealth projects, such as TeleCheck-AF, will provide insight into the additional value and potential limitations of mHealth strategies to remotely manage AF patients. Such mHealth infrastructures may be well suited within an integrated AF-clinic, which may require redesign of practice and reform of health care systems. How to cite this article: Hermans ANL, van der Velden RMJ, Gawalko M, et al. On-demand mobile health infrastructures to allow comprehensive remote atrial fibrillation and risk factor management through teleconsultation.

Smart Wearables for Cardiac Monitoring—Real-World Use beyond Atrial Fibrillation

“…In this regard, leveraging data via remote patient monitoring (RPM) from wearable devices may help overcome this obstacle. In the real-world setting, teleconsultations instead of outpatient clinic visits have been made possible by implementing an on-demand app-based heart rate and rhythm monitoring infrastructure [ 81 , 82 , 83 ].…”

Sleep apnea and atrial fibrillation: Update 2020

“…Some pacemakers can perform continuous monitoring of sleep disordered breathing [16] . Additionally, mHealth applications and technologies such as Bluetooth-linked balances may allow a widespread and affordable infrastructure for longitudinal risk factor identification and monitoring [37] , [38] , [39] , [40] , [41] . Implementation of infrastructures for longitudinal assessment of variables such as risk factors, lifestyle components or rate and rhythm information require adaptation of existing care coordination and clinical pathways [37] .…”

The European TeleCheck-AF project on remote app-based management of atrial fibrillation during the COVID-19 pandemic: centre and patient experiences

“…However, during the COVID-19 pandemic, scheduled outpatient consultations were cancelled to keep vulnerable patients out of the hospital, and face-to-face appointments were converted into teleconsultations. 3 Although teleconsultation solutions can produce remote situations that are relatively similar to face-to-face interaction, 4 the effective remote monitoring and management of AF patients is limited, mainly due to the absence of heart rate and rhythm information of the patient. As a response, different centres all over the world started to combine their teleconsultations with mobile health (mHealth) solutions for remote heart rate and rhythm monitoring.…”