Digital Monitoring and Electronic Patient-Reported Outcomes Collection
Following Atrial Fibrillation Ablation.
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.