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

Lindsey R. Mitrani, MD; Isaac Goldenthal, MS; Jamie Leskowitz, RD; Elaine Y. Wan, MD, FHRS; Jose Dizon, MD; Deepak Saluja, MD; Ruth Masterson Creber, PhD; Megan Reading Turchioe, PhD; Robert R. Sciacca, EndScD; Hasan Garan, MD; Kathleen T. Hickey, EdD; Judith Korner, MD, PhD; Angelo B. Biviano, MD, FHRS

Cardiovascular Digital Health Journal (Feb 2022)

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

Lindsey R. Mitrani, MD,
Isaac Goldenthal, MS,
Jamie Leskowitz, RD,
Elaine Y. Wan, MD, FHRS,
Jose Dizon, MD,
Deepak Saluja, MD,
Ruth Masterson Creber, PhD,
Megan Reading Turchioe, PhD,
Robert R. Sciacca, EndScD,
Hasan Garan, MD,
Kathleen T. Hickey, EdD,
Judith Korner, MD, PhD,
Angelo B. Biviano, MD, FHRS

Affiliations

Lindsey R. Mitrani, MD: Division of Cardiology, Department of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
Isaac Goldenthal, MS: Division of Cardiology, Department of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
Jamie Leskowitz, RD: Division of Cardiology, Department of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
Elaine Y. Wan, MD, FHRS: Division of Cardiology, Department of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
Jose Dizon, MD: Division of Cardiology, Department of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
Deepak Saluja, MD: Division of Cardiology, Department of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
Ruth Masterson Creber, PhD: Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
Megan Reading Turchioe, PhD: Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
Robert R. Sciacca, EndScD: Division of Cardiology, Department of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
Hasan Garan, MD: Division of Cardiology, Department of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
Kathleen T. Hickey, EdD: Columbia University, School of Nursing, New York, New York
Judith Korner, MD, PhD: Division of Cardiology, Department of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York
Angelo B. Biviano, MD, FHRS: Division of Cardiology, Department of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, New York; Address reprint requests and correspondence: Dr Angelo B. Biviano, Division of Cardiology, Department of Medicine, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY 10032.

Journal volume & issue: Vol. 3, no. 1
pp. 14 – 20

Abstract

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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.

Published in Cardiovascular Digital Health Journal

ISSN: 2666-6936 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system; Medicine: Medicine (General): Medical technology
Website: https://www.journals.elsevier.com/cardiovascular-digital-health-journal

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