Digital remote monitoring in adult congenital heart disease patients Lessons learned and recommendations

In cardiology telemedicine is introduced for care for patients with heart failure and (possible) arrhythmia. mHealth telemonitoring might be a powerful tool for remote diagnosing and managing arrhythmias, heart failure and blood pressure. This thesis focuses on the question whether introducing digital remote patient monitoring (DRPM) by a dedicated mHealth program in the routine care management of adult congenital heart disease (ACHD) patients improves care for these patients.
The project was funded with a successful crowdfunding campaign. Critical success factors contributing to this success are described. The crowdfunding campaign could have met the needs of donors, leading to enforcing of the public engagement. Appropriate patient selection for participation in mHealth contributes to an efficient use of mHealth and lower emergency care utilization. Results of a study to evaluate a mHealth telemonitoring program for managing arrhythmia, heart failure and blood pressure in symptomatic ACHD patients are presented. mHealth can be an acceptable alternative for ILR implantation in detecting arrhythmia in symptomatic ACHD patients in respect to diagnostic yield, safety and management decisions, especially in those without syncope.
A narrative review is presented of scientific publications published regarding extended arrhythmia screening in ACHD patients. The number of studies found was limited. The studies found demonstrated a higher rate of arrhythmia and bradycardia detection leading to clinical care changes by extending the time of rhythm monitoring to more than 24 hours. Although several non-invasive diagnostic tools are, in symptomatic patients, a good alternative for ILRs, the optimal mode of detection is still unclear.
Future directions for DRPM and key points for future DRPM research are given.