Self-Reported Mobile Health-Based Risk Factor and CHA2DS2-VASc-Score Assessment in Patients With Atrial Fibrillation: TeleCheck-AF Results.

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.

• Authors: Astrid N L Hermans, Monika Gawałko, Henrike A K Hillmann, Afzal Sohaib, Rachel M J van der Velden, Konstanze Betz, Dominique Verhaert, Daniel Scherr, Julia Meier, Arian Sultan, Daniel Steven, Elena Terentieva, Ron Pisters, Martin Hemels, Leonard Voorhout, Piotr Lodziński, Bartosz Krzowski, Dhiraj Gupta, Nikola Kozhuharov, Henri Gruwez, Kevin Vernooy, Nikki A H A Pluymaekers, Jeroen M Hendriks, Martin Manninger, David Duncker, Dominik Linz
• Journal: Frontiers in cardiovascular medicine (Front Cardiovasc Med) Vol. 8 Pg. 757587 ( 2021) ISSN: 2297-055X [Print] Switzerland
• PMID: 35127847 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Hermans, Gawałko, Hillmann, Sohaib, van der Velden, Betz, Verhaert, Scherr, Meier, Sultan, Steven, Terentieva, Pisters, Hemels, Voorhout, Lodziński, Krzowski, Gupta, Kozhuharov, Gruwez, Vernooy, Pluymaekers, Hendriks, Manninger, Duncker and Linz.