Cited by 106Telemedicine and Telehealth ImplementationAtrial Fibrillation Management and OutcomesMobile Health and mHealth Applications

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The European TeleCheck-AF project on remote app-based management of atrial fibrillation during the COVID-19 pandemic: centre and patient experiences

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Abstract

AIMS: TeleCheck-AF is a multicentre international project initiated to maintain care delivery for patients with atrial fibrillation (AF) during COVID-19 through teleconsultations supported by an on-demand photoplethysmography-based heart rate and rhythm monitoring app (FibriCheck®). We describe the characteristics, inclusion rates, and experiences from participating centres according the TeleCheck-AF infrastructure as well as characteristics and experiences from recruited patients. METHODS AND RESULTS: Three surveys exploring centre characteristics (n = 25), centre experiences (n = 23), and patient experiences (n = 826) were completed. Self-reported patient characteristics were obtained from the app. Most centres were academic (64%) and specialized public cardiology/district hospitals (36%). Majority of the centres had AF outpatient clinics (64%) and only 36% had AF ablation clinics. The time required to start patient inclusion and total number of included patients in the project was comparable for centres experienced (56%) or inexperienced in mHealth use. Within 28 weeks, 1930 AF patients were recruited, mainly for remote AF control (31% of patients) and AF ablation follow-up (42%). Average inclusion rate was highest during the lockdown restrictions and reached a steady state at a lower level after easing the restrictions (188 vs. 52 weekly recruited patients). Majority (>80%) of the centres reported no problems during the implementation of the TeleCheck-AF approach. Recruited patients [median age 64 (55-71), 62% male] agreed that the FibriCheck® app was easy to use (94%). CONCLUSION: Despite different health care settings and mobile health experiences, the TeleCheck-AF approach could be set up within an extremely short time and easily used in different European centres during COVID-19.

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Registry

Crossref · 10.1093/europace/euab050

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Figures

Figure 1 Number of recruited patients per clinical centre and European geographical location of centres. Inclusion rates apply to centres that included ten or more patients. Columns showed number of recruited patients; yellow line showed the real number of patients that started heart rhythm and rate monitoring (status from 9 October 2020).
Figure 1 Number of recruited patients per clinical centre and European geographical location of centres. Inclusion rates apply to centres that included ten or more patients. Columns showed number of recruited patients; yellow line showed the real number of patients that started heart rhythm and rate monitoring (status from 9 October 2020).CC BY-NC · PubMed Central
Figure 2 Timeline from centre inclusion to first ten patients’ enrolment. Centres with previous experience with mHealth (yellow), dates of centre inclusion (blue), and days of patients’ enrolment (grey) are highlighted. The date of 26 March was chosen as start of the ‘first week’ as the first centre joined the project, beside Maastricht centre, and official date of TeleCheck-AF was announced at 4 April, therefore first week counts nine instead of seven days.
Figure 2 Timeline from centre inclusion to first ten patients’ enrolment. Centres with previous experience with mHealth (yellow), dates of centre inclusion (blue), and days of patients’ enrolment (grey) are highlighted. The date of 26 March was chosen as start of the ‘first week’ as the first centre joined the project, beside Maastricht centre, and official date of TeleCheck-AF was announced at 4 April, therefore first week counts nine instead of seven days.CC BY-NC · PubMed Central
Figure 3 Weekly inclusion rate per country. *Weekly inclusion rate of the ‘first week’ was calculated for nine days instead of seven days. Inclusion rate was highest during the lockdown restrictions (n=829; 188 per week) lasting for 1st to 7th weeks and reached a steady state at a lower level after easing the restrictions (n=1101; 52 per week) lasting from 8th to 28th weeks (status from 9 October 2020). To simplify calculations, the border between the ‘lockdown’ and ‘easing the restrictions’ was chosen for the 7th week as it was the week in which the last country introduced the easing the restrictions. AT, Austria; BE, Belgium; DE, Germany; IE, Ireland; NL, The Netherlands; PL, Poland; PVI, pulmonary vein isolation; SE, Sweden.
Figure 3 Weekly inclusion rate per country. *Weekly inclusion rate of the ‘first week’ was calculated for nine days instead of seven days. Inclusion rate was highest during the lockdown restrictions (n=829; 188 per week) lasting for 1st to 7th weeks and reached a steady state at a lower level after easing the restrictions (n=1101; 52 per week) lasting from 8th to 28th weeks (status from 9 October 2020). To simplify calculations, the border between the ‘lockdown’ and ‘easing the restrictions’ was chosen for the 7th week as it was the week in which the last country introduced the easing the restrictions. AT, Austria; BE, Belgium; DE, Germany; IE, Ireland; NL, The Netherlands; PL, Poland; PVI, pulmonary vein isolation; SE, Sweden.CC BY-NC · PubMed Central
Figure 4 Centre experiences (n = 23). AF, atrial fibrillation; PPG, photoplethysmography.
Figure 4 Centre experiences (n = 23). AF, atrial fibrillation; PPG, photoplethysmography.CC BY-NC · PubMed Central
Figure 5 Patient experiences (n = 826).
Figure 5 Patient experiences (n = 826).CC BY-NC · PubMed Central

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Metadata

Authors
Gawałko, M., Duncker, D., Manninger, M., van der Velden, R. M. J., Hermans, A. N. L., Verhaert, D. V. M., Pison, L., Pisters, R., Hemels, M., Sultan, A., Steven, D., Gupta, D., Heidbuchel, H., Sohaib, A., Wijtvliet, P., Tieleman, R., Gruwez, H., Chun, J., Schmidt, B., Keaney, J. J., Müller, P., Lodziński, P., Svennberg, E., Hoekstra, O., Jansen, W. P. J., Desteghe, L., de Potter, T., Tomlinson, D. R., Neubeck, L., Crijns, H. J. G. M., Pluymaekers, N. A. H. A., Hendriks, J. M., Linz, D., & the TeleCheck-AF investigators
Affiliations
  • Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, 6202 AZ Maastricht, The Netherlands
  • Medizinische Hochschule Hannover (DE)
  • Medical University of Graz (AT)
  • Maastricht University Medical Centre (NL)
  • Radboud University Medical Center (NL)
  • Ziekenhuis Oost-Limburg (BE)
  • Rijnstate Hospital (NL)
  • University of Cologne (DE)
  • Liverpool Heart and Chest Hospital (GB)
  • Antwerp University and University Hospital, Antwerp, Belgium
  • Barts Heart Centre, West Smithfield, London, UK
  • Martini Ziekenhuis (NL)
  • KU Leuven (BE)
  • Cardiovascular Center Bethanien (DE)
  • Mater Misericordiae University Hospital (IE)
  • University Hospital Münster (DE)
  • Medical University of Warsaw (PL)
  • Karolinska University Hospital (SE)
  • Tergooi (NL)
  • Jessa Hospital (BE)
  • Cardiovascular Center, Onze Lieve Vrouwziekenhuis, Aalst, Belgium
  • Derriford Hospital (GB)
  • Edinburgh Napier University (GB)
  • Royal Adelaide Hospital (AU)
  • University of Copenhagen (DK)
Corresponding author
Linz, Dominik
Venue
EP Europace
Published
2021-04-02
Volume
23
Issue
7
Pages
1003-1015
ISSN
  • 1099-5129 (ISSN-L)
  • 1532-2092
OpenAlex
W3149244439
Cited by
106
References
19
Citations by year
2026: 6 · 2025: 18 · 2024: 27 · 2023: 13 · 2022: 28 · 2021: 14
FWCI
17.77
Type
journal article
Language
en
Open access
Locations
  • EP Europace (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, cc-by-nc)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by-nc)
  • Edinburgh Napier Research Repository (Edinburgh Napier University) (publishedVersion, cc-by-nc)
  • Lirias (KU Leuven) (submittedVersion, cc-by-nc)
  • Research Output (Edinburgh Napier University) (submittedVersion, cc-by-nc)
  • Document Server@UHasselt (UHasselt) (submittedVersion, cc-by-nc)
  • Radboud Repository (Radboud University) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion, other-oa)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Funders
  • Maastricht Universitair Medisch Centrum
  • Biosense Webster
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
atrial fibrillation, remote patient monitoring, COVID-19 pandemic, photoplethysmography, mobile health apps, remote patient care, teleconsultation, patient recruitment, patient experience, lockdown measures
MeSH terms
COVID-19, SARS-CoV-2, Atrial Fibrillation, Communicable Disease Control, Female, Humans, Male, Middle Aged, Pandemics, Mobile Applications, Patient Outcome Assessment

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