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. 2019 Jan;27(1):30-37.
doi: 10.1007/s12471-018-1201-6.

First real-world experience with mobile health telemonitoring in adult patients with congenital heart disease

M A C Koole  1   2   3 , D Kauw  4   5 , M M Winter  4   6 , D A J Dohmen  7 , I I Tulevski  6 , R de Haan  6 , G A Somsen  6 , M P Schijven  8 , D Robbers-Visser  4 , B J M Mulder  4 , B J Bouma  4 , M J Schuuring  4   9
Affiliations

First real-world experience with mobile health telemonitoring in adult patients with congenital heart disease

M A C Koole et al. Neth Heart J. 2019 Jan.

Abstract

Background: 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.

Methods: 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.

Results: 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%.

Conclusion: The first results indicate that this program is feasible with high adherence.

Keywords: adult congenital heart disease; arrhythmia; e-Health; heart failure; m-Health.

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Conflict of interest statement

D.A.J. Dohmen, A.G. Somsen and I.I. Tulevski are shareholders in ventures supplying hardware and software implemented in the methods of this study. M.A.C. Koole, D. Kauw, M.M. Winter, R. de Haan, M.P. Schijven, D. Robbers-Visser, B.J.M. Mulder, B.J. Bouma and M.J. Schuuring declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the study, N = number
Fig. 2
Fig. 2
Event-free survival of patients with adult congenital heart disease (dotted line events during m‑Health telemonitoring, straight line events in historical data)
Fig. 3
Fig. 3
Patient-reported outcome measures (light blue baseline, blue 3 months, dark blue 6 months). Baseline is set as median. (Self-management PAM-13, quality of life, general EQ-5D-5L, Safety CaReQoL safety, Physical CaReQoL physical restrictions, Social and emotional CaReQoL social and emotional)
Fig. 4
Fig. 4
176 rhythms in 17 patients during palpitations in the first 3 months, N = number, %
See this image and copyright information in PMC

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