Can an app change the way Nova Scotians live with A Fib?

HALIFAX – A large-scale study of a common heart condition called atrial fibrillation will soon be underway in Nova Scotia.

Atrial fibrillation, also known as A Fib, is an electrical issue of the heart, according to cardiologist Dr. Jafna Cox, who is also a co-investigator of the study.

“The heart in the upper chambers beats very quickly and irregularly,” he said.

Cox said symptoms of A Fib include rapid heartbeats, feeling light-headed and passing out. He estimates approximately 20,000 Nova Scotians are afflicted by the condition.

Cox and fellow researchers at Integrated Management Program Advancing Community Treatment of Atrial Fibrillation, IMPACT-AF, are currently seeking 4,000 A Fib patients to be part of a research study.

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Half of the participants will use an app or web-based tool to input and monitor their vital conditions, such as heart rate and blood pressure, as well as keep track of their lab tests and bloodwork. The other half will continue their treatments as normal.

“As the patient changes their weight, as the patient’s blood pressure is being recorded, as the patient’s heart rate is being assessed and recorded…what the computer does is it takes all of those bits of information and begins to take a look at how the patient is doing and then begins to inform the physician if there is anything that needs to be done,” he said.

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The number of A Fib patients is expected to rise in the coming years as the population ages, and Cox said it is important to use technology to help physicians manage their patients and for patients to manage themselves better.

“[If] their kidney function has suddenly [worsened] or their blood is not being thinned enough, this will alert on the screen that the physician has available to them. It will be an icon they can click on, they will see their A Fib patients, they’ll see which ones have red alerts,” Cox said.
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Chronic disease management is often treated at the specialist level, said Raza Abidi, health infomatics researcher for the project.

He said the app allows specialist care to be brought to the primary care level.

The researchers said the hope is the app will reduce hospitalizations since it will be proactive rather than reactive to how a patient is doing.

“It is doing an analysis of the patient data, monitoring the patient all the time and then responding in advance so the event can be avoided even before it actually takes place,” Abidi said.

“If so many times the blood pressure is high, the patients will be called in and somebody will assess their blood pressure. If their blood pressure is truly found to be high then an adjustment can be made in the medication,” Cox said.

Living with A Fib

Joanna Hogan, 76, of Bedford was diagnosed with A Fib four years ago. She said the diagnosis stunned her.

“The doctor did his usual blood pressure check and then he took my pulse. I know my doctor and I know from the look on his face that I had a problem,” she said.

Hogan said she has since made dramatic changes to her life to keep her condition under control.

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“I don’t eat a lot of red meat anymore. I’ve added flaxseed to my breakfast,” she said about her dietary changes.

Hogan also walks three times a week at the gym and said that, most importantly, she has become more aware of her physical limits.

“You learn very quickly. You can go so far and then I’m tired. I know I have to stop,” she said.

Hogan, who is enrolled in the A Fib study, said she is excited to be a part of the research.

“I think it’s a subject that happens to an awful lot of people. I just think the more we know, the better we can handle stuff,” she said.

Researchers are still enrolling for the study and expect enrolment to be complete by early 2016. Participants will be followed for one year, meaning results are expected in 2017.

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