Mobile app-based symptom-rhythm correlation assessment in patients with persistent atrial fibrillation
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Mobile app-based symptom-rhythm correlation assessment in patients with persistent atrial fibrillation. / Hermans, Astrid N L; Gawalko, Monika; Slegers, Daniek P J; Andelfinger, Nora; Pluymaekers, Nikki A H A; Verhaert, Dominique V M; van der Velden, Rachel M J; Betz, Konstanze; Evens, Stijn; Luermans, Justin G L M; den Uijl, Dennis W; Baumert, Mathias; Nguyen, Hien L; Isaksen, Jonas L; Kanters, Jørgen K; Rienstra, Michiel; Vernooy, Kevin; Van Gelder, Isabelle C; Hendriks, Jeroen M; Linz, Dominik.
In: International Journal of Cardiology, Vol. 367, 2022, p. 29-37.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Mobile app-based symptom-rhythm correlation assessment in patients with persistent atrial fibrillation
AU - Hermans, Astrid N L
AU - Gawalko, Monika
AU - Slegers, Daniek P J
AU - Andelfinger, Nora
AU - Pluymaekers, Nikki A H A
AU - Verhaert, Dominique V M
AU - van der Velden, Rachel M J
AU - Betz, Konstanze
AU - Evens, Stijn
AU - Luermans, Justin G L M
AU - den Uijl, Dennis W
AU - Baumert, Mathias
AU - Nguyen, Hien L
AU - Isaksen, Jonas L
AU - Kanters, Jørgen K
AU - Rienstra, Michiel
AU - Vernooy, Kevin
AU - Van Gelder, Isabelle C
AU - Hendriks, Jeroen M
AU - Linz, Dominik
N1 - Copyright © 2022. Published by Elsevier B.V.
PY - 2022
Y1 - 2022
N2 - BACKGROUND: The assessment of symptom-rhythm correlation (SRC) in patients with persistent atrial fibrillation (AF) is challenging. Therefore, we performed a novel mobile app-based approach to assess SRC in persistent AF.METHODS: Consecutive persistent AF patients planned for electrical cardioversion (ECV) used a mobile app to record a 60-s photoplethysmogram (PPG) and report symptoms once daily and in case of symptoms for four weeks prior and three weeks after ECV. Within each patient, SRC was quantified by the SRC-index defined as the sum of symptomatic AF recordings and asymptomatic non-AF recordings divided by the sum of all recordings.RESULTS: Of 88 patients (33% women, age 68 ± 9 years) included, 78% reported any symptoms during recordings. The overall SRC-index was 0.61 (0.44-0.79). The study population was divided into SRC-index tertiles: low (<0.47), medium (0.47-0.73) and high (≥0.73). Patients within the low (vs high) SRC-index tertile had more often heart failure and diabetes mellitus (both 24.1% vs 6.9%). Extrasystoles occurred in 19% of all symptomatic non-AF PPG recordings. Within each patient, PPG recordings with the highest (vs lowest) tertile of pulse rates conferred an increased risk for symptomatic AF recordings (odds ratio [OR] 1.26, 95% coincidence interval [CI] 1.04-1.52) and symptomatic non-AF recordings (OR 2.93, 95% CI 2.16-3.97). Pulse variability was not associated with reported symptoms.CONCLUSIONS: In patients with persistent AF, SRC is relatively low. Pulse rate is the main determinant of reported symptoms. Further studies are required to verify whether integrating mobile app-based SRC assessment in current workflows can improve AF management.
AB - BACKGROUND: The assessment of symptom-rhythm correlation (SRC) in patients with persistent atrial fibrillation (AF) is challenging. Therefore, we performed a novel mobile app-based approach to assess SRC in persistent AF.METHODS: Consecutive persistent AF patients planned for electrical cardioversion (ECV) used a mobile app to record a 60-s photoplethysmogram (PPG) and report symptoms once daily and in case of symptoms for four weeks prior and three weeks after ECV. Within each patient, SRC was quantified by the SRC-index defined as the sum of symptomatic AF recordings and asymptomatic non-AF recordings divided by the sum of all recordings.RESULTS: Of 88 patients (33% women, age 68 ± 9 years) included, 78% reported any symptoms during recordings. The overall SRC-index was 0.61 (0.44-0.79). The study population was divided into SRC-index tertiles: low (<0.47), medium (0.47-0.73) and high (≥0.73). Patients within the low (vs high) SRC-index tertile had more often heart failure and diabetes mellitus (both 24.1% vs 6.9%). Extrasystoles occurred in 19% of all symptomatic non-AF PPG recordings. Within each patient, PPG recordings with the highest (vs lowest) tertile of pulse rates conferred an increased risk for symptomatic AF recordings (odds ratio [OR] 1.26, 95% coincidence interval [CI] 1.04-1.52) and symptomatic non-AF recordings (OR 2.93, 95% CI 2.16-3.97). Pulse variability was not associated with reported symptoms.CONCLUSIONS: In patients with persistent AF, SRC is relatively low. Pulse rate is the main determinant of reported symptoms. Further studies are required to verify whether integrating mobile app-based SRC assessment in current workflows can improve AF management.
U2 - 10.1016/j.ijcard.2022.08.021
DO - 10.1016/j.ijcard.2022.08.021
M3 - Journal article
C2 - 35963443
VL - 367
SP - 29
EP - 37
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -
ID: 316682177