E-health in patients with atrial fibrillation

The term E-health, or information and communication technology, has been introduced during the last decade and is currently an evolving topic. The term refers to techno-logy that supports health care providers in the management of chronic diseases and continuing care. The World Health Organization defines E-health as ‘the transfer of health resources and health care by electronic means’.1 According to this definition, it is a method of using health resources more appropriately and efficiently. Significant examples in terms of home telemonitoring can be found in the management of patients with heart failure (HF); a positive impact on self-care and self-efficacy in patients with HF2 and their admission to hospital3 has been demonstrated. A recent summary of systematic reviews has shown improved clinical outcomes in patients with HF using home-based E-health technology.4 The technology investigated included video consultations, mobile telemonitoring, telemonitoring based on automated devices and web-based telemonitoring. E-health (device-based telemonitoring and mobile telemonitoring) proved to be effective in reducing the relative risk of HF-related admission to hospital (from a relative risk of 0.64 to 0.86) compared with usual care (absolute risk from 3.7 to 8.2%) and the relative risk of all-cause mortality (from 0.60 to 0.85) and absolute risk from 1.4 to 6.5% compared with usual care.4 These results are strongly dependent on the type of technology and the patient population and hence care should be taken in ge-neralizing these E-health effects.5 Despite these promising results however, the implementation of E-health tools in the care of patients with HF is low internationally.6