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http://hdl.handle.net/1942/36026
Title: | Remote Heart Rhythm Monitoring by Photoplethysmography-Based Smartphone Technology After Cardiac Surgery: Prospective Observational Study | Authors: | Lamberigts, Marie Van Hoof, Lucas Proesmans, Tine VANDERVOORT, Pieter GRIETEN, Lars Haemers, Peter Rega, Filip |
Issue Date: | 2021 | Publisher: | JMIR PUBLICATIONS, INC | Source: | JMIR mhealth and uhealth, 9 (4) , (Art N° e26519) | Abstract: | Background: Atrial fibrillation (AF) is the most common arrhythmia after cardiac surgery, yet the precise incidence and significance of arrhythmias after discharge home need to be better defined. Photoplethysmography (PPG)-based smartphone apps are promising tools to enable early detection and follow-up of arrhythmias. Objective: By using a PPG-based smartphone app, we aimed to gain more insight into the prevalence of AF and other rhythm-related complications upon discharge home after cardiac surgery and evaluate the implementation of this app into routine clinical care. Methods: In this prospective, single-center trial, patients recovering from cardiac surgery were asked to register their heart rhythm 3 times daily using a Food and Drug Administration-approved PPG-based app, for either 30 or 60 days after discharge home. Patients with permanent AF or a permanent pacemaker were excluded. Results: We included 24 patients (mean age 60.2 years, SD 12 years; 15/23, 65% male) who underwent coronary artery bypass grafting and/or valve surgery. During hospitalization, 39% (9/23) experienced postoperative AF. After discharge, the PPG app reported AF or atrial flutter in 5 patients. While the app notified flutter in 1 patient, this was a false positive, as electrocardiogram revealed a 2nd-degree, 2:1 atrioventricular block necessitating a permanent pacemaker. AF was confirmed in 4 patients (4/23, 17%) and interestingly, was associated with an underlying postoperative complication in 2 participants (pneumonia n=1, pericardial tamponade n=1). A significant increase in the proportion of measurements indicating sinus rhythm was observed when comparing the first to the second month of follow-up (P<.001). In the second month of follow-up, compliance was significantly lower with 2.2 (SD 0.7) measurements per day versus 3.0 (SD 0.8) measurements per day in the first month (P=.002). The majority of participants (17/23, 74%), as well as the surveyed primary care physicians, experienced positive value by using the app as they felt more involved in the postoperative rehabilitation. Conclusions: Implementation of smartphone-based PPG technology enables detection of AF and other rhythm-related complications after cardiac surgery. An association between AF detection and an underlying complication was found in 2 patients. Therefore, smartphone-based PPG technology may supplement rehabilitation after cardiac surgery by acting as a sentinel for underlying complications, rhythm-related or otherwise. | Notes: | Lamberigts, M (corresponding author), Univ Hosp Leuven, Dept Cardiac Surg, Herestr 49, B-3000 Leuven, Belgium. marie.lamberigts@kuleuven.be |
Keywords: | cardiac surgery; postoperative follow-up; cardiac rehabilitation;;postoperative arrhythmias; atrial fibrillation; photoplethysmography;;home-monitoring | Document URI: | http://hdl.handle.net/1942/36026 | ISSN: | 2291-5222 | e-ISSN: | 2291-5222 | DOI: | 10.2196/26519 | ISI #: | WOS:000708586900004 | Rights: | This is an open-access article distributed under the terms of the Creative Commons Attribution License | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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remote.pdf | Published version | 2.05 MB | Adobe PDF | View/Open |
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