Innovative remote monitoring for atrial fibrillation

Published: 23 September 2024

Dr Laura Joyce has received a Heart Foundation grant to pilot remote follow-up care for patients presenting at the emergency department with atrial fibrillation using a smartphone app and nurse-led calls. This study aims to reduce unnecessary hospital visits and improve care, especially for rural patients.

Dr Laura Joyce, an Emergency Medicine Specialist at Christchurch Hospital, has been awarded a Small Project Grant by the Heart Foundation to lead an innovative pilot study aimed at improving the follow-up care of patients with atrial fibrillation (AF) who present with symptoms at the emergency department (ED). 

AF is the most common abnormal heart rhythm in adults, with over 60,000 ED presentations annually in New Zealand alone. In most Australasian EDs, patients with AF either receive cardioversion – a procedure to restore normal heart rhythm – or are admitted to the hospital, with up to 40% requiring admission.

Christchurch Hospital Emergency Department has developed a clinical AF pathway that has shown success in safely reducing unnecessary cardioversions and hospitalisations. Laura’s project through the University of Otago seeks to explore a more patient-friendly approach. 

“This pilot study will assess the feasibility of using remote follow-up to screen patients in their own homes the day after their ED visit,” she says. “It could be a truly revolutionary approach to help our EDs cope with the high volume of visits they are currently experiencing.”

Simple smartphone app to monitor AF

The study will use a smartphone application (‘app’) to measure heart rhythm, coupled with a nurse-led telephone call to guide patients through the process.

The proposed method is simple yet innovative. Patients will be loaned a smartphone and instructed to use the app. The following day, a nurse will call to check on their symptoms and guide them through using the app. The app detects AF by having the patient lie down with the phone on their chest for one minute. This remote monitoring process aims to determine whether the patient’s heart rhythm has returned to normal, potentially eliminating the need for them to travel to a clinic for treatment.

“A key aspect of this study will be gathering feedback from patients on the usability and acceptability of the remote follow-up process,” says Laura. “Understanding the patient experience will be crucial in evaluating the success of this approach.”

If proven effective, remote follow-up could significantly benefit those living in rural areas or in regions without easy access to cardiology specialists. The potential to centralise remote follow-up and provide specialist advice from a distance could revolutionise how AF patients are managed across New Zealand.

Dr Gerry Devlin, Heart Foundation Medical Director, highlights the significance of this study: “Atrial fibrillation is becoming an increasingly common heart rhythm disorder which often results in hospital presentation. With the help of new technologies informed by best practice guidelines, we can hopefully provide patient reassurance, get people back to their own homes and avoid unnecessary hospital appointments.”