Risk Factor Management of Atrial Fibrillation Using mHealth: The Atrial Fibrillation – Helping Address Care with Remote Technology (AF-HEART) Pilot Study

Abstract Background Personalized treatment of atrial fibrillation (AF) risk factors using mHealth and telehealth may improve patient outcomes. Objective The purpose of this study was to assess the feasibility of the A trial F ibrillation He lping A ddress Care with R emote T echnology (AF-HEART) intervention on the following patient outcomes: (i) heart rhythm tracking, (ii) weight, alcohol, blood pressure (BP) and sleep apnea reduction, (iii) AF symptom reduction, (iv) and quality of life (QOL) improvement. Methods A total of 20 patients with AF undergoing antiarrhythmic therapy, cardioversion, and/or catheter ablation were enrolled and followed for 6 months. The AF-HEART intervention included: remote heart rhythm, weight, and BP tracking, televisits with a dietician focusing on AF risk factors; and referrals for sleep apnea and hypertension treatment. Results Patients transmitted a median of 181 rhythm recordings during the 6-month follow-up period. Patients lost an average of 3.5 kilograms at 6 months (p = 0.005). Patients had improved SF-12 scores (p = 0.01), AFSS score (p = 0.01), EQLS (p = 0.006), and AFEQT Global Score (p = 0.03). There was significant correlation between weight loss and decrease in symptom severity (r = -0.45, p = 0.05), and % weight loss and decrease in symptom severity (r = -0.49, p = 0.03). Conclusions This study described the feasibility of the AF-HEART intervention for: i) consistent remote tracking of heart rhythm, weight, and BP, ii) achievement of weight loss, iii) reduction of symptoms, and iv) improvement in QOL. Expansion to a larger randomized study is planned.