Projectdetails

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Evaluation of an app based education and clinical follow using handheld ECG recordings in patients undergoing catheter ablation of atrial fibrillation

Keywords:
cardiology Ehealth telemonitoring

Researchers:
drs. E. Metting
Y. Blaauw

Nature of the research:
prospective observational study

Fields of study:
health sciences cardiology

Background / introduction
In the Netherlands the prevalence of atrial fibrillation is approximately 1.4% (2017) 1 . Catheter ablation is an established treatment for patients with symptomatic atrial fibrillation. In 2019, 5500 patients with atrial fibrillation in the Netherlands received such a treatment. The decision to opt/ schedule a patient for catheter ablations is based on the symptoms of the patients, the expected procedural success and complication rate and should ideally be a shared decision of the patient and the cardiologist. After the procedure, the guidelines suggest regular visits to the outpatient clinic as well as ECG and Holter monitoring. Especially the latter is time consuming because the holters need to be picked up at the hospital where the sensors are applied to the patient. After monitoring patients have to hand in the holters at the hospital. In the first year after the ablation this is scheduled at 3, 6 and 12 months.
There is a new methodology available that will be used in the coming years by the UMCG. An app will be developed that will be used in the AF ablation care pathway. This app can be used to give information about the procedure to the patient, collect questionnaire data and ECG recordings. Special telemonitoring ECG devices are now available that can be used daily by the patient at home without intervention for a health care professional. The data from this device is send to an application on patient’s smartphone. All relevant data will be sent to a dashboard and this information is available to the treating cardiologist or nurse. The healthcare professional uses this dashboard to monitor patients and can timely interfere. The potential benefit of this procedure is that patients don't have to visit the hospital as often as with the regular procedure. Moreover the patient can be better informed about the procedure in a structured way. More information about the procedure and healthcare professionals can provide more personalised treatment because there are more measurement recorded.
The UMCG will start using the AF ablation app including telemonitoring for ablation patients that are treated within the Hartnet collaboration (https://www.hartnetnoordnederland.nl/), this is an integrated care pathway where healthcare professionals including GPs provide care close to the patient.
Research question / problem definition
The research question is: what is the effect of introducing this app on clinical outcomes such as adverse events, symptoms status, functional status and health related quality of life.
Workplan
we are looking for a master student with analystical skills who will be involved in this project by collecting and analyzing data.
References
1 Ontwikkelingen in prevalentie van atriumfibrilleren en antitrombotica voorschriften. L.P.T. Joosten, E.J.B. van Eerde, F.H. Rutten, G.J. Geersing
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