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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Hermans, ANL; Gawałko, M; Hillmann, HAK; Sohaib, A; van, der, Velden, RMJ; Betz, K; Verhaert, D; Scherr, D; Meier, J; Sultan, A; Steven, D; Terentieva, E; Pisters, R; Hemels, M; Voorhout, L; Lodziński, P; Krzowski, B; Gupta, D; Kozhuharov, N; Gruwez, H; Vernooy, K; Pluymaekers, NAHA; Hendriks, JM; Manninger, M; Duncker, D; Linz, D.
Self-Reported Mobile Health-Based Risk Factor and CHA₂DS₂-VASc-Score Assessment in Patients With Atrial Fibrillation: TeleCheck-AF Results.
Front Cardiovasc Med. 2021; 8: 757587 Doi: 10.3389/fcvm.2021.757587 [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz

Manninger-Wünscher Martin

Scherr Daniel

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Abstract:

Introduction: The TeleCheck-AF approach is an on-demand mobile health (mHealth) infrastructure incorporating mobile app-based heart rate and rhythm monitoring through teleconsultation. We evaluated feasibility and accuracy of self-reported mHealth-based AF risk factors and CHA₂DS₂-VASc-score in atrial fibrillation (AF) patients managed within this approach. Materials and Methods: Consecutive patients from eight international TeleCheck-AF centers were asked to complete an app-based 10-item questionnaire related to risk factors, associated conditions and CHA₂DS₂-VASc-score components. Patient's medical history was retrieved from electronic health records (EHR). Results: Among 994 patients, 954 (96%) patients (38% female, median age 65 years) completed the questionnaire and were included in this analysis. The accuracy of self-reported assessment was highest for pacemaker and anticoagulation treatment and lowest for heart failure and arrhythmias. Patients who knew that AF increases the stroke risk, more often had a 100% or ≥80% correlation between EHR- and app-based results compared to those who did not know (27 vs. 14% or 84 vs. 77%, P = 0.001). Thromboembolic events were more often reported in app (vs. EHR) in all countries, whereas higher self-reported hypertension and anticoagulant treatment were observed in Germany and heart failure in the Netherlands. If the app-based questionnaire alone was used for clinical decision-making on anticoagulation initiation, 26% of patients would have been undertreated and 6.1%-overtreated. Conclusion: Self-reported mHealth-based assessment of AF risk factors is feasible. It shows high accuracy of pacemaker and anticoagulation treatment, nevertheless, displays limited accuracy for some of the CHA₂DS₂-VASc-score components. Direct health care professional assessment of risk factors remains indispensable to ensure high quality clinical-decision making.

Find related publications in this database (Keywords)

atrial fibrillation

mobile health

photoplethysmography

risk factors

thromboembolic risk

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