The European TeleCheck-AF project on remote app-based management of atrial fibrillation: ablation outpatient clinic experience

Abstract Funding Acknowledgements Type of funding sources: None. Background TeleCheck-AF is a multicentre international project initiated to implement remote care delivery for patients with atrial fibrillation (AF) through teleconsultations supported by an on-demand photoplethysmography (PPG)-based heart rate/rhythm monitoring app. Purpose The current sub-study of the TeleCheck-AF project aimed to provide the first real-world dataset on feasibility and patient experience of this standardized mobile health (mHealth) infrastructure in the clinical setting of follow-up after catheter ablation. Methods This sub-study included consecutive patients in each centre who have undergone catheter ablation. In the post-ablation period, at the 3-, 6- or 12-month visit, patients were provided with the app and were instructed to perform 60-second heart rate/rhythm recordings three times daily and in case of symptoms for seven consecutive days prior to teleconsultation. Recurrences of AF were documented by PPG-based app (FibriCheck®). Motivation was defined as number of days in which the expected number of measurements (≥three/day) were performed per number of days over the entire prescription period. Adherence was defined as number of performed measurements per number of expected measurements over the entire prescription period. Patients’ experience was based on a survey sent to each patient via e-mail. Results Data from 588 patients (median age 63 [56-70] years, 39% female) from eight centres from six European countries were analysed. Patients with both optimal motivation (100%) and adherence (≥100%) constituted 158 (29%) of the study population and had more often previously undergone an ablation for AF (77% vs 62%), P=0.005) and had a higher number of AF PPG recordings (mean 1.9 vs 0.8, P=0.017). The app gave patients a safe feeling (70%) and automated reminders were useful (68%). Patients agreed that the app was easy to use (97%), easy to install (89%) and that they would like to use the app in the future (70%). In 95 (16%) patients, AF was detected by the app. There was no statistically significant difference between patients with (vs without) app-based detected AF, except a higher prevalence of prescribed three or more cardiovascular drugs (65% vs 53%, P=0.032) and beta-blockers (64% vs 52%, P=0.033). Patients with (vs without) app-based detected AF had higher optimal adherence (66% vs 41%, P<0.001). Conclusion The TeleCheck-AF approach is feasible and associated with high adherence as well as motivation to use the app and with optimal patient experience. Whether this approach can replace conventional rhythm follow-up after catheter ablation required further study.