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

Résumé fourni par la source

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. 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. 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). 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). 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.

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