Cardiac symptom burden and arrhythmia recurrence drives digital health use: results from the iHEART randomized controlled trial.
Ruth M Masterson Creber, Meghan Reading Turchioe, Angelo Biviano and 7 others
PMID 34009326WHAT IT FOUND
Among 105 patients using an ECG monitor after AF treatment, more premature atrial contractions were linked to moderate or frequent use.
Age and technology experience were not linked to use. This is not proof that monitoring changes outcomes.
Key findings
01In the iHEART intervention arm, 105 AliveCor users averaged 8.8 uses per week over 6 months; 28 (27%) were frequent users, 44 (42%) moderate users, and 33 (31%) infrequent users.
02Compared with infrequent users, moderate users were 17% more likely to have more premature atrial contractions, 6% more likely to have higher AFEQT symptom burden scores indicating less symptom burden, and 4% less likely to have higher treatment concern scores indicating less treatment concern; frequent users were 23% more likely to have more premature atrial contractions.
03Age and technology experience were not associated with use over 6 months.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This was a secondary analysis of only the iHEART intervention arm, so it describes associations with use, not proof that any component caused higher use. Participants received several components at once: an iPhone, cellular service, an AliveCor monitor, and behavioural motivational text messages, so the contribution of any single component cannot be separated. The study was done at one electrophysiology unit in a large urban academic medical centre, and the sample lacked gender, racial, ethnic, and sociodemographic diversity, so it may not represent many patients with atrial fibrillation. Missing 6-month follow-up survey data meant some predictor variables were available only at baseline, so changes in symptoms, quality of life, or self-management over time could not be examined. Average weekly use was used, so short-term fluctuations in engagement over the 6 months were not captured. Only 11 participants (10%) used the AliveCor symptom-reporting feature, so the exact symptoms during atrial fibrillation or premature atrial contractions could not be evaluated.
Declared interests
The iHEART trial was funded by the National Institute of Nursing Research of the National Institutes of Health. The supplied text reports no other conflict-of-interest disclosures.
The easy way to misread this
Do not conclude that the AliveCor monitor alone caused more frequent use. Participants also received an iPhone, cellular service, and behavioural motivational text messages, and this was an analysis of use among intervention-arm patients, not a randomized comparison. Do not conclude that older or less tech-experienced patients cannot use remote monitoring; age and technology experience were not associated with use.