Physical activity, patient-reported symptoms, and clinical events: Insights into postprocedural recovery from personal digital devices

Victoria L. Bartlett, Joseph S. Ross, Nilay D Shah, Laura Ciaccio, Joseph G. Akar, Peter A. Noseworthy, Sanket S. Dhruva

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Personal digital devices may offer insights into patient recovery and an approach for remote monitoring after procedures. Objective: To examine associations between activity measured using personal digital devices, patient-reported outcome measures (PROMs), and clinical events among patients after catheter ablation for atrial fibrillation (AF) or bariatric surgery. Methods: We aggregated personal digital device, PROM, and electronic health record data in a study conducted at 2 health systems. We used Fitbit devices for step count assessments, KardiaMobile for cardiac rhythm assessments, and PROMs for pain and palpitations over 5 weeks. Results: Among 59 patients, 30 underwent AF ablation and 29 bariatric surgery. Thirty-six patients (63%) reported pain. There was no difference in median [interquartile range] daily steps between patients with and those without pain (4419 [3286–7041] vs 3498 [2609–5888]; P =.23). Among AF ablation patients, 21 (70%) reported palpitations. Median daily steps were lower among those with palpitations than among those without (4668 [3021–6116] vs 8040 [6853–10,394]; P =.03). When accounting for within-subject correlation, recordings of AF were associated with a significant mean decrease in median daily steps (–351; 95% confidence interval –524 to –177; P <.01). Patients who received a new antiarrhythmic drug prescription had AF recorded in a median of 5 [5–5] of 5 total weeks, whereas patients who did not receive a new antiarrhythmic recorded AF in a median of 1 [0–3] week (P =.02). Conclusion: Personal digital device and PROM data can provide insight into postprocedural recovery outside of usual clinical settings and may inform follow-up and clinical decision-making. (ClinicalTrials.gov

Original languageEnglish (US)
Pages (from-to)212-221
Number of pages10
JournalCardiovascular Digital Health Journal
Volume2
Issue number4
DOIs
StatePublished - Aug 2021

Keywords

  • Ablation
  • Activity
  • Atrial fibrillation
  • Bariatric surgery
  • Digital health
  • Patient-reported outcomes
  • Postprocedural recovery
  • Remote monitoring
  • Wearable devices

ASJC Scopus subject areas

  • Biomedical Engineering
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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