Virtual heart clinic may improve arrhythmia patients’ survival and quality of life

Patients like Joyce Cormier, with Dr. Parkash (r) taking part in the atrial fibrillation virtual clinic receive devices to track physical activity, heart rate and rhythm, so researchers can see how activity impacts their heart health during the study
Patients (like Joyce Cormier, with Dr. Parkash, right) taking part in the atrial fibrillation “virtual clinic” receive devices to track physical activity, heart rate and rhythm, so researchers can see how activity impacts their heart health over the study period.

Atrial fibrillation (AF) is an irregular or rapid heartbeat that affects 10 per cent of the population over the age of 80. AF is a chronic condition that regularly sends people to emergency with shortness of breath, chest pain and other severe symptoms. Unmanaged, it can lead to stroke, heart failure or sudden cardiac death.

Researchers at NSHA are pioneering ways to improve AF patients’ health and quality of life. Cardiologists Dr. Ratika Parkash and Dr. John Sapp are collaborating with behavioural psychologist Dr. Chris Blanchard and Halifax-based Kinduct Technologies to develop and pilot a virtual clinic to follow patients with AF.

“We found in earlier research that AF patients are able to manage their condition best when they make regular visits to a nurse-run clinic,” explains Dr. Parkash, who is lead investigator on the NSHA Research Fund-supported project. “But this is not an affordable service for the health care system, so we decided to see if we could replicate the benefits using a virtual platform.”

The virtual AF clinic will allow patients to access their own health data—including heart rate, blood pressure, weight, food intake, and activity level—through an online portal. The portal will also connect them to their personalized arrhythmia care plan, feedback on their progress, and advise about when to seek immediate or urgent medical attention. If they need more support, they can receive online coaching from an AF-trained nurse.

“Patients will be evaluated by a specialist and, if they enroll in the study, taught how to use the portal,” says Dr. Parkash. “This includes instructions for entering their own data—such as weight, heart rate and activity levels—into the portal.”

As Dr. Parkash explains, many patients with AF are afraid to exercise, but vigorous exercise is one of the most effective ways to manage the disease.

“We want to empower AF patients to take control of their condition,” she says. “Patients can dramatically reduce their risk by exercising, limiting alcohol, eating healthy, and managing blood pressure.”

After 100 patients have been followed through the virtual clinic for a year, the researchers will compare their rates of AF-related emergency visits and cardiac hospitalizations to those of patients who received standard care. Their main goal for the pilot study is to confirm patients use the portal.

“If patients embrace the concept and find it beneficial,” says Dr. Parkash, “we will scale up to a larger study that will validate the impact on health outcomes and system use.”

This article is part of the Nova Scotia Health Authority Research Annual Report 2017.