基于智能手机应用程序的导管消融术后患者心房颤动时间和症状近似值:TeleCheck-AF 项目的数据。

IF 7.9 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Europace Pub Date : 2024-10-03 DOI:10.1093/europace/euae247
Emma Sandgren, Astrid N L Hermans, Monika Gawalko, Konstanze Betz, Afzal Sohaib, Chi Ho Fung, Henrike A K Hillmann, Rachel M J van der Velden, Dominique Verhaert, Daniel Scherr, Arian Sultan, Daniel Steven, Ron Pisters, Martin Hemels, Piotr Lodziński, Sevasti-Maria Chaldoupi, Dhiraj Gupta, Henri Gruwez, Nikki A H A Pluymaekers, Jeroen M Hendriks, Malene Nørregaard, Martin Manninger, David Duncker, Dominik Linz
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引用次数: 0

摘要

背景和目的:与房颤消融术后的分类房颤节律复发相比,减轻房颤(AF)负担是首选的结果测量指标。在 TeleCheck-AF 项目的这项子分析中,我们测试了基于智能手机应用程序的房颤和/或症状时间近似值的可行性:方法:在房颤消融术后的 12 个月随访期间,计划接受至少一次远程会诊的患者接受指导,使用基于智能手机光电血压计 (PPG) 的应用程序进行症状和心律同步监测,每天 3 次,持续 1 周。对房颤和/或症状所花费的时间(记录百分比、负荷、天数百分比)、房颤和/或症状的时间聚集(密度)以及症状与节律相关性(SRC)进行了评估:共纳入 484 名患者(60% 为男性,62±9.9 岁)。患者的依从性、积极性和满意度都很高。房颤记录百分比、房颤负荷和房颤天数百分比(rs= 0.88-0.95)与症状记录百分比、症状负荷和症状天数百分比(rs= 0.95-0.98)呈正相关。SRC 与症状时间(rs=-0.65--0.90)和房颤时间(rs=-0.31--0.34)呈负相关。在消融前为阵发性房颤、监测期间为房颤的患者中,87%(39/44)的低密度评分为 90%("持续性房颤模式")。消融前持续性房颤患者的相应数字分别为48%(n=11/23)和43%(n=10/23):基于应用程序的按需同步心律和症状评估可提供房颤和/或症状所花费时间的客观代用指标以及症状与心律的相关性,这可能有助于评估房颤消融术后的房颤和症状预后。
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Smartphone app-based approximation of time spent with atrial fibrillation and symptoms in patients after catheter ablation: data from the TeleCheck-AF project.

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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来源期刊
Europace
Europace 医学-心血管系统
CiteScore
10.30
自引率
8.20%
发文量
851
审稿时长
3-6 weeks
期刊介绍: EP - Europace - European Journal of Pacing, Arrhythmias and Cardiac Electrophysiology of the European Heart Rhythm Association of the European Society of Cardiology. The journal aims to provide an avenue of communication of top quality European and international original scientific work and reviews in the fields of Arrhythmias, Pacing and Cellular Electrophysiology. The Journal offers the reader a collection of contemporary original peer-reviewed papers, invited papers and editorial comments together with book reviews and correspondence.
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