AUTHOR=Hermans Astrid N. L. , Gawałko Monika , Hillmann Henrike A. K. , Sohaib Afzal , van der Velden Rachel M. J. , Betz Konstanze , Verhaert Dominique , Scherr Daniel , Meier Julia , Sultan Arian , Steven Daniel , Terentieva Elena , Pisters Ron , Hemels Martin , Voorhout Leonard , Lodziński Piotr , Krzowski Bartosz , Gupta Dhiraj , Kozhuharov Nikola , Gruwez Henri , Vernooy Kevin , Pluymaekers Nikki A. H. A. , Hendriks Jeroen M. , Manninger Martin , Duncker David , Linz Dominik 

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

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=8

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.757587

DOI=10.3389/fcvm.2021.757587

ISSN=2297-055X

ABSTRACT=<sec><title>Introduction</title><p>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 CHA<sub>2</sub>DS<sub>2</sub>-VASc-score in atrial fibrillation (AF) patients managed within this approach.</p></sec><sec><title>Materials and Methods</title><p>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 CHA<sub>2</sub>DS<sub>2</sub>-VASc-score components. Patient's medical history was retrieved from electronic health records (EHR).</p></sec><sec><title>Results</title><p>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%, <italic>P</italic> = 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.</p></sec><sec><title>Conclusion</title><p>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 CHA<sub>2</sub>DS<sub>2</sub>-VASc-score components. Direct health care professional assessment of risk factors remains indispensable to ensure high quality clinical-decision making.</p></sec>