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Digital Monitoring and Electronic Patient-Reported Outcomes Collection Following Atrial Fibrillation Ablation.
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  • João Almeida,
  • Rafael Teixeira,
  • Paulo Fonseca,
  • Marco Oliveira,
  • Helena Gonçalves,
  • João Primo,
  • Ricardo Fontes-Carvalho,
  • Sérgio Barra,
  • Juan-Pablo Martínez,
  • Rute Almeida
João Almeida
Unidade Local de Saude de Vila Nova de Gaia/Espinho

Corresponding Author:joaotgalmeida@gmail.com

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Rafael Teixeira
Unidade Local de Saude de Vila Nova de Gaia/Espinho
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Paulo Fonseca
Unidade Local de Saude de Vila Nova de Gaia/Espinho
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Marco Oliveira
Unidade Local de Saude de Vila Nova de Gaia/Espinho
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Helena Gonçalves
Unidade Local de Saude de Vila Nova de Gaia/Espinho
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João Primo
Unidade Local de Saude de Vila Nova de Gaia/Espinho
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Ricardo Fontes-Carvalho
Unidade Local de Saude de Vila Nova de Gaia/Espinho
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Sérgio Barra
Royal Papworth Hospital NHS Foundation Trust
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Juan-Pablo Martínez
University of Zaragoza
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Rute Almeida
Universidade do Porto Faculdade de Medicina
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Abstract

Introduction: Atrial fibrillation (AF) remains a challenging condition to manage traditionally in clinical practice, and despite improvements in digital health, its impact on clinical outcomes remains uncertain. This study aims to assess the feasibility of a structured digital-blended follow-up for AF ablation patients, incorporating electronic patient-reported outcomes measures (PROM) while evaluating its impact on one-year clinical outcomes. Methods: In this retrospective observational study, we included patients enrolled in a structured two-year digital program starting in January 2021. This featured a web platform for physicians to record clinical variables and a patient-centred mobile application to report PROM (AFEQT and PROMIS). Clinical outcomes were compared with those from a retrospective conventionally managed cohort (2017-2020) after propensity score matching (n=363 per group). Results: Until May 2024, 421 patients were enrolled (mean age: 60.9 years; 33.0% female). Over a median follow-up of 546 days, 64% of patients used the app monthly, and completeness rates for AFEQT and PROMIS questionnaires were 80 and 50%, respectively. At 12 months, significant improvements were observed for AFEQT and PROMIS scores (Cognitive and Physical Function, Anxiety, and Depression). Arrhythmia recurrence significantly influenced the rates of changes for AFEQT, Depression, and Physical Function (p<0.05 for interactions). One-year clinical outcomes were similar between matched groups, although the median time to anti-arrhythmic intervention after AF recurrence was significantly lower in the digital group (-126 days, p<0.001). Conclusion: Systematic electronic PROM collection after AF ablation is feasible in clinical practice. Structured digital-blended integrated care guarantees continuity of AF management, facilitating earlier interventions.
14 Jan 2025Submitted to Journal of Cardiovascular Electrophysiology
15 Jan 2025Review(s) Completed, Editorial Evaluation Pending
15 Jan 2025Submission Checks Completed
15 Jan 2025Assigned to Editor
17 Jan 2025Reviewer(s) Assigned