Koole M A C, Kauw D, Winter M M, Dohmen D A J, Tulevski I I, de Haan R, Somsen G A, Schijven M P, Robbers-Visser D, Mulder B J M, Bouma B J, Schuuring M J
Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Cardiology Centers of the Netherlands, Amsterdam, The Netherlands.
Neth Heart J. 2019 Jan;27(1):30-37. doi: 10.1007/s12471-018-1201-6.
Arrhythmias and heart failure are common and invalidating sequelae in adult patients with congenital heart disease (CHD). Mobile health (m-Health) enables daily monitoring and a timely response that might prevent deterioration. We present an observational prospective registry to evaluate feasibility of an m‑Health telemonitoring program for managing arrhythmia, heart failure and blood pressure in symptomatic adults with CHD.
Symptomatic adult patients with CHD are enrolled in an m‑Health telemonitoring program, which evaluates single-lead ECG, blood pressure and weight measurements. In case of symptoms extra measurements could be performed. Data are collected by mobile apps, matched with individualised thresholds. Patients are contacted if thresholds were exceeded or if arrhythmias were found, for treatment adjustments or reassurance. Data on emergency care utilisation, hospitalisation and patient-reported outcome measures are used to assess quality of life and self-management.
129 symptomatic CHD patients were invited to participate, 55 participated. Reasons for refusing consent included too time consuming to participate in research (30) and to monitor vital signs (14). At baseline 22 patients were in New York Heart Association class ≥ II heart failure, 43 patients had palpitations or documented arrhythmias, and 8 had hypertension. Mean follow-up was 3.0 months, one patient dropped out, and adherence was 97%.
The first results indicate that this program is feasible with high adherence.
心律失常和心力衰竭是成年先天性心脏病(CHD)患者常见且致残的后遗症。移动健康(m-Health)可实现日常监测并及时做出反应,这可能预防病情恶化。我们开展了一项观察性前瞻性注册研究,以评估m-Health远程监测项目对有症状的成年CHD患者心律失常、心力衰竭和血压进行管理的可行性。
有症状的成年CHD患者参加m-Health远程监测项目,该项目评估单导联心电图、血压和体重测量值。出现症状时可进行额外测量。数据通过移动应用程序收集,并与个体化阈值进行匹配。如果超过阈值或发现心律失常,则联系患者进行治疗调整或给予安心指导。使用急诊护理利用、住院和患者报告的结局指标数据来评估生活质量和自我管理情况。
邀请了129名有症状的CHD患者参与,55名参与。拒绝同意的原因包括参与研究太耗时(30例)和监测生命体征太耗时(14例)。基线时,22例患者处于纽约心脏协会II级及以上心力衰竭,43例患者有心悸或记录的心律失常,8例有高血压。平均随访3.0个月,1例患者退出,依从率为97%。
初步结果表明该项目可行且依从性高。