Implementing Self management using eHealth for monitoring and management after Catheter ablation in the treatment of Atrial fibrillatioN.
A study on the diagnostic accuracy and the effects of eHealth rhythm monitoring on patient related outcomes, clinical management and health outcomes.

Atrial fibrillation is a major public health problem and is the most common
cardiac arrhythmia, affecting an estimated 4.5 million people in Europe. The
true prevalence of atrial fibrillation is likely underestimated because
episodes are often sporadic; therefore, it is challenging to detect and record
an occurrence in a *real world* setting. Catheter ablation, pulmonary vein
isolation (PVI), has shown to be a safe and effective treatment strategy for AF
and therefore it has become an established invasive strategy for drug
refractory AF.
After PVI, 30-60% of patients show recurrent episodes of AF. Previous studies
have demonstrated that the overall prevalence of undiagnosed AF is
underestimated, and active screening and monitoring should be pursued. Prompt
recording of a 12-lead ECG is an effective and cost-effective method to
document chronic forms of AF, but paroxysmal AF is more often missed. The
technology to detect paroxysmal, self-terminating AF episodes is rapidly
evolving. Evidence shows that prolonged ECG monitoring enhances the detection
of undiagnosed AF. The detection of asymptomatic and paroxysmal AF by new
technologies, such as smartphone cases with ECG electrodes, smart watches, and
blood pressure machines with AF detection algorithms, has not yet been formally
evaluated against an established arrhythmia detection method, but looks
promising. The use and implementation of electronic-health (eHealth) is being
encouraged by the Hearth Rhythm Society(HRS) and European Hearth Rhythm
Association (EHRA), as stated in their position statements of 2012 and 2015.
This study will evaluate a mobile eHealth device to detect recurrent atrial
arrhythmias after PVI and to evaluate the impact on patient outcomes and
quality of life.

Optimise post PVI management using ambulant continuous patient-driven eHealth
monitoring after catheter ablation in the treatment of atrial fibrillation.


Primary Objective:
1) Determine the effect of eHealth on clinical management, outcomes and quality
of life compared to standard of care follow up

Secondary Objectives:
1) Determine the diagnostic performance and reliability
2) Determine the usability and applicability in daily practice.

Longitudinal cohort study

Patients receive additional means for cardiac rhythm monitoring to encourage
self-management and early detection. Thereby, recurrent cardiac arrhythmias
might be recognised earlier and improved quality of life might be achieved
earlier. Standard of care will not be restricted unless the treating
cardiologist deems it appropriate.