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  • Title: Smartphone app-based approximation of time spent with atrial fibrillation and symptoms in patients after catheter ablation: data from the TeleCheck-AF project.
    Author: Sandgren E, Hermans ANL, Gawalko M, Betz K, Sohaib A, Fung CH, Hillmann HAK, van der Velden RMJ, Verhaert D, Scherr D, Sultan A, Steven D, Pisters R, Hemels M, Lodziński P, Chaldoupi SM, Gupta D, Gruwez H, Pluymaekers NAHA, Hendriks JM, Nørregaard M, Manninger M, Duncker D, Linz D.
    Journal: Europace; 2024 Oct 03; 26(10):. PubMed ID: 39344253.
    Abstract:
    AIMS: Reduction of atrial fibrillation (AF) burden is the preferred outcome measure over categorical AF rhythm recurrence after AF ablation. In this sub-analysis of the TeleCheck-AF project, we tested the feasibility of smartphone app-based approximation of time spent with AF and/or symptoms. METHODS AND RESULTS: Patients scheduled for at least one teleconsultation during the 12-month follow-up after AF ablation were instructed to use a smartphone photoplethysmography-based application for simultaneous symptom and rhythm monitoring three times daily for 1 week. Proxies of time spent with AF and/or symptoms (% recordings, load, and % days), temporal aggregation of AF and/or symptoms (density), and symptom-rhythm correlation (SRC) were assessed. In total, 484 patients (60% male, 62 ± 9.9 years) were included. Adherence, motivation, and patient satisfaction were high. %AF recordings, AF load, and %AF days (rs = 0.88-0.95) and %symptom recordings, symptom load, and %symptom days (rs = 0.95-0.98) showed positive correlations. The SRC correlated negatively with time spent with symptoms (rs = -0.65-0.90) and with time spent with AF (rs = -0.31-0.34). In patients with paroxysmal AF before ablation and AF during the monitoring period, 87% (n = 39/44) had a low-density score <50% ('paroxysmal AF pattern') while 5% (n = 2/44) had a high-density score >90% ('persistent AF pattern'). Corresponding numbers for patients with persistent AF before ablation were 48% (n = 11/23) and 43% (n = 10/23), respectively. CONCLUSION: On-demand, app-based simultaneous rhythm and symptom assessment provides objective proxies of time spent with AF and/or symptoms and SRC, which may assist in assessing AF and symptom outcomes after AF ablation.
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