Patient report outcomes in cryoballoon ablation of atrial fibrillation during the COVID Era: Insights from the 1STOP project

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Atrial fibrillation (n=865). Intervention: MYCRYO APP (smartphone application) vs. Standard follow-up visits (No-App group). Primary outcome: Annual rate of atrial fibrillation recurrence (p=0.007).

Q: What does this research mean for the field?

Using a web-based mobile application to monitor patient-reported outcomes following cryoballoon ablation is associated with a significantly higher detected annual rate of atrial fibrillation recurrence. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Giulio Molon; Giuseppe Arena; Claudio Tondo; Danilo Ricciardi; Pietro Rossi; Paolo Pieragnoli; Roberto Verlato; Massimiliano Manfrin; Giulia Girardengo; Giuseppe Matteo Campisi; Domenico Pecora; Mario Luzi; Saverio Iacopino

doi:10.1007/s10840-023-01561-5

May 13, 2023Journal of Interventional Cardiac ElectrophysiologyOpen Access

Patient report outcomes in cryoballoon ablation of atrial fibrillation during the COVID Era: Insights from the 1STOP project

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Why the study?

Atrial fibrillation symptoms are subjective yet clinically important patient outcomes, prompting evaluation of a web-based App to collect AF-related symptoms after cryoablation.

Does the use of a web-based App to collect AF-related symptoms improve the detection of AF recurrence in patients undergoing cryoballoon ablation for atrial fibrillation?

Study Design

Type

Observational (n=865)

Multicenter

Yes

Structured PICO

Does the use of a web-based App to collect AF-related symptoms improve the detection of AF recurrence in patients undergoing cryoballoon ablation for atrial fibrillation?

P

Population

865 patients with paroxysmal or persistent atrial fibrillation who underwent index pulmonary vein isolation by cryoablation, followed for a mean of 7.9 months.

E

Exposure

Use of a web-based smartphone application (MYCRYOAPP) to collect AF-related symptoms and general health status at least once per week or when symptoms occurred.

C

Comparator

Standard follow-up visits according to the clinical practice of each center without the use of the App.

O

Outcome

Atrial fibrillation recurrence during follow-up (after a 90-day blanking period) and the impact of AF-related symptoms declared by patients on AF recurrence.patient reported

Main Result

Absolute Event Rate: 10.99% vs 7.36%

p-value: p=0.007

The use of a smartphone app to collect patient-reported outcomes after atrial fibrillation ablation is feasible and significantly increases the detection of clinical recurrences compared to standard follow-up.

Limitations

Non-randomized project with potential selection bias in patient selection and App usage
No data on patient education or the reasons for declining the App
Lack of validated Quality of Life (QoL) questionnaires
Conducted during the COVID-19 pandemic, which may have led to canceled or remote visits, potentially under-estimating AF recurrence
Short-term follow-up
Non-randomized project with potential selection bias
No data on patient education or reasons for declining App usage
No standardized follow-up protocol shared amongst centers
Use of non-validated Quality of Life questionnaires
Conducted during the COVID-19 pandemic, which may have underestimated AF recurrence detection

Implication

App-based PRO collection was associated with higher AF recurrence detection post-ablation; hypothesis-generating and requires randomized confirmation before practice change.

Abstract

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Discussion

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Cite This Study

Molon et al. (2023) conducted an observational in Atrial fibrillation (n=865). MYCRYO APP (smartphone application) vs. Standard follow-up visits (No-App group) was evaluated on Annual rate of atrial fibrillation recurrence (p=0.007).

synapsesocial.com/papers/6aa7b369ac18924c765743cf https://doi.org/10.1007/s10840-023-01561-5

Topics

Atrial fibrillation

Persistent AF management

AF ablation outcomes

Anticoagulation in AF

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Patient report outcomes in cryoballoon ablation of atrial fibrillation during the COVID Era: Insights from the 1STOP project

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Topics

Patient report outcomes in cryoballoon ablation of atrial fibrillation during the COVID Era: Insights from the 1STOP project

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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