Frontiers in Cardiovascular Medicine (Jan 2022)

Self-Reported Mobile Health-Based Risk Factor and CHA2DS2-VASc-Score Assessment in Patients With Atrial Fibrillation: TeleCheck-AF Results

  • Astrid N. L. Hermans,
  • Monika Gawałko,
  • Monika Gawałko,
  • Monika Gawałko,
  • Henrike A. K. Hillmann,
  • Afzal Sohaib,
  • Afzal Sohaib,
  • Rachel M. J. van der Velden,
  • Konstanze Betz,
  • Dominique Verhaert,
  • Dominique Verhaert,
  • Daniel Scherr,
  • Daniel Scherr,
  • Julia Meier,
  • Arian Sultan,
  • Daniel Steven,
  • Elena Terentieva,
  • Ron Pisters,
  • Martin Hemels,
  • Martin Hemels,
  • Leonard Voorhout,
  • Piotr Lodziński,
  • Bartosz Krzowski,
  • Dhiraj Gupta,
  • Nikola Kozhuharov,
  • Nikola Kozhuharov,
  • Henri Gruwez,
  • Henri Gruwez,
  • Kevin Vernooy,
  • Nikki A. H. A. Pluymaekers,
  • Jeroen M. Hendriks,
  • Jeroen M. Hendriks,
  • Martin Manninger,
  • David Duncker,
  • Dominik Linz,
  • Dominik Linz,
  • Dominik Linz,
  • Dominik Linz

DOI
https://doi.org/10.3389/fcvm.2021.757587
Journal volume & issue
Vol. 8

Abstract

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IntroductionThe TeleCheck-AF approach is an on-demand mobile health (mHealth) infrastructure incorporating mobile app-based heart rate and rhythm monitoring through teleconsultation. We evaluated feasibility and accuracy of self-reported mHealth-based AF risk factors and CHA2DS2-VASc-score in atrial fibrillation (AF) patients managed within this approach.Materials and MethodsConsecutive patients from eight international TeleCheck-AF centers were asked to complete an app-based 10-item questionnaire related to risk factors, associated conditions and CHA2DS2-VASc-score components. Patient's medical history was retrieved from electronic health records (EHR).ResultsAmong 994 patients, 954 (96%) patients (38% female, median age 65 years) completed the questionnaire and were included in this analysis. The accuracy of self-reported assessment was highest for pacemaker and anticoagulation treatment and lowest for heart failure and arrhythmias. Patients who knew that AF increases the stroke risk, more often had a 100% or ≥80% correlation between EHR- and app-based results compared to those who did not know (27 vs. 14% or 84 vs. 77%, P = 0.001). Thromboembolic events were more often reported in app (vs. EHR) in all countries, whereas higher self-reported hypertension and anticoagulant treatment were observed in Germany and heart failure in the Netherlands. If the app-based questionnaire alone was used for clinical decision-making on anticoagulation initiation, 26% of patients would have been undertreated and 6.1%—overtreated.ConclusionSelf-reported mHealth-based assessment of AF risk factors is feasible. It shows high accuracy of pacemaker and anticoagulation treatment, nevertheless, displays limited accuracy for some of the CHA2DS2-VASc-score components. Direct health care professional assessment of risk factors remains indispensable to ensure high quality clinical-decision making.

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