Risk factor management of atrial fibrillation using mHealth: The Atrial Fibrillation - Helping Address Care with Remote Technology (AF-HEART) Pilot Study

Lindsey R Mitrani; Isaac Goldenthal; Jamie Leskowitz; Elaine Y Wan; Jose Dizon; Deepak Saluja; Ruth Masterson Creber; Megan Reading Turchioe; Robert R Sciacca; Hasan Garan; Kathleen T Hickey; Judith Korner; Angelo B Biviano

doi:10.1016/j.cvdhj.2021.11.003

Risk factor management of atrial fibrillation using mHealth: The Atrial Fibrillation - Helping Address Care with Remote Technology (AF-HEART) Pilot Study

Cardiovasc Digit Health J. 2021 Nov 24;3(1):14-20. doi: 10.1016/j.cvdhj.2021.11.003. eCollection 2022 Feb.

Affiliations

¹ Division of Cardiology, Department of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York.
² Department of Population Health Sciences, Weill Cornell Medicine, New York, New York.
³ Columbia University, School of Nursing, New York, New York.

Abstract

Background: Personalized treatment of atrial fibrillation (AF) risk factors using mHealth and telehealth may improve patient outcomes.

Objective: The purpose of this study was to assess the feasibility of the Atrial Fibrillation Helping Address Care with Remote Technology (AF-HEART) intervention on the following patient outcomes: (1) heart rhythm tracking; (2) weight, alcohol, blood pressure (BP), and sleep apnea reduction; (3) AF symptom reduction; and (4) quality-of-life (QOL) improvement.

Methods: A total of 20 patients with AF undergoing antiarrhythmic therapy, cardioversion, and/or catheter ablation were enrolled and followed for 6 months. The AF-HEART intervention included remote heart rhythm, weight, and BP tracking; televisits with a dietician focusing on AF risk factors; and referrals for sleep apnea and hypertension treatment.

Results: Patients transmitted a median of 181 rhythm recordings during the 6-month follow-up period. Patients lost an average of 3.5 kilograms at 6 months (P = .005). Patients had improved SF-12 scores (P = .01), AFSS score (P = .01), EQ-5D score (P = .006), and AFEQT Global Score (P = .03). There was significant correlation between weight loss and decrease in symptom severity (r = -0.45, P = .05), and between % weight loss and decrease in symptom severity (r = -0.49, P = .03).

Conclusion: This study described the feasibility of the AF-HEART intervention for (1) consistent remote tracking of heart rhythm, weight, and BP; (2) achievement of weight loss; (3) reduction of symptoms; and (4) improvement in QOL. Expansion to a larger randomized study is planned.

Keywords: Atrial fibrillation; Electrocardiogram; Mobile health; Obesity; Risk factor management.