Astrid Lauberg

No News is Good News: Remote Monitoring of Implantable Cardioverter-Defibrillator Patients

Implantable cardioverter-defibrillator (ICD) patients have increased safety when connected to remote monitoring as ICD problems and issues are instantly discovered compared to patients without a monitor. While remote monitoring is intrusive in the domestic environment, little HCI research has investigated how people live and interact with such monitoring technologies. We conducted a study with 19 ICD patients and their spouses using diaries and interviews. Our findings illustrate that our participants were satisfied with the monitoring despite the fact that they had almost no knowledge of the data collected and they lacked feedback from the monitor on transmission and operation. Based on our findings, we describe a safety paradox for remote monitoring as participants experienced less safety while being safer, and identify privacy and surveillance concerns in the unequal monitoring of ICD patients.

Patient-reported outcomes at hospital discharge from Heart Centres, a national cross-sectional survey with a register-based follow-up: the DenHeart study protocol

Introduction Patient reported health status, which includes symptom burden, functional status and quality of life, is an important measure of health. Differences in health status between diagnostic groups within cardiology have only been sparsely investigated. These outcomes may predict morbidity, mortality, labour market affiliation and healthcare utilisation in various diagnostic groups. A national survey aiming to include all cardiac diagnostic groups from a total Heart Centre population has been designed as the DenHeart survey. Methods and analysis DenHeart is designed as a cross-sectional survey with a register-based follow-up. All diagnostic groups at the five national Heart Centres are included during 1 year (15 April 2013 to 15 April 2014) and asked to fill out a questionnaire at hospital discharge. The total eligible population, both responders and non-responders, will be followed in national registers. The following instruments are used: SF-12, Hospital Anxiety and Depression Scale, EQ-5D, Brief Illness Perception Questionnaire (B-IPQ), HeartQoL and Edmonton Symptom Assessment Scale. The following variables are collected from national registers: action diagnosis, procedures, comorbidity, length of hospital stay, type of hospitalisation, visits to general practitioners and other agents in primary healthcare, dispensed prescription medication, vital status and cause of death. Labour market affiliation, sick leave, early retirement pension, educational degree and income will be collected from registers. Frequency distributions and multiple logistic regression analyses will be used to describe and assess differences in patient reported outcomes at hospital discharge between diagnostic groups and in-hospital predicting factors. Cox proportional hazards regression models with age as the time scale will be used to investigate associations between patient reported outcomes at baseline and morbidity/mortality, labour market affiliation and healthcare utilisation after 1 year. Ethics and dissemination The study complies with the Declaration of Helsinki. The study has been approved by the Danish Data Protection Agency: 2007-58-0015/30-0937 and registered at ClinicalTrials.gov (NCT01926145). Study findings will be disseminated widely through peer reviewed publications and conference presentations.

Obesity and smoking is widespread in patients with ischemia and heart failure, but not in congenital heart disease and heart transplant patients: results from the national DenHeart survey The study is funded by the heart centres and the Novo Nordisk Foundation

no: 166 Flowchart Abstracts S33 ! 2016 European Journal of Preventive Cardiology Framingham Risk Score and the PRECARD Scale. Statistical analysis involved uniand multivariate linear regression and logistic regression. Results: The CREP program enrolled 139 patients participation (45%). Included 56.8% men and 43.2% women. Smoking was associated with lower chance to participate compared to non-smokers (OR = 0.42, 95%CI = 0.16 0.88). There was small but signification difference between men and women in change in risk assessment according to the Framingham Risk Score (0.69%). Participation in supervised physical exercise program increased the effectiveness of the program assessment by SPE (0.22 points per each session). There was a strong correlation between the effectiveness of the program after 1 year and the result of evaluation directly after CREP completion. The better was the direct effect of the program the lower risk after 1 year. Conclusions: Cigarette smoking was associated with twofold lower participation in the CREP. Participation in supervised physical exercise program was associated with significantly greater effectiveness of the program. Additionally, male sex and older age had a negative effect on risk change according to the Framingham Risk Score. Significant correlation between the effectiveness of CREP after its completion and its distant consequences were reported. 168 Impact of cardiac rehabilitation on dietary habits and aerobic exercise after an acute coronary syndrome E Elio Venturini, C Sansoni, V Venturini, L Lo Conte, M Siragusa, N Bosio, R Testa Department of Cardiology Civic Hospital , Cecina (LI), Italy, University of Pisa, Department of Veterinary Sciences, Pisa, Italy Topic: Cardiac rehabilitation Purpose: aerobic exercise and the dietary habits, if maintained overtime, can be useful tools not only to attenuate the progression of coronary artery disease but also to induce a regression of the plaque. We evaluated the effect of a cardiology rehabilitation outpatient program (CR OP) on diet and physical activity in patients after acute coronary syndrome (ACS). Methods: we studied 50 P (67% men, mean age 67.3 10 y) enrolled in a CR OP duration 2 months, 24 sessions) after an ACS. The Mediterranean Diet (MD) was assessed with a translated version of the Med Diet Score which provides 0-8 points (the larger the value, the better adherence to diet). The International Physical Activity Questionnaire, in the short version, was used to assess the level of physical activity (PA): less than 700 METs /week subject inactive, 700-2519 sufficiently active, more than 2520 very active. Both questionnaires were administered before and after 1 year of the end of the program. It was provided a motivational telephone call, operated by nurses, at 3 and 6 months after the end of the CR OP. Results: the results are reported in the table below. The level of physical activity, too low at the beginning of the OP, was increased by CR; but above all, the good results persisted even a year later. Regarding the MD was observed a not significant improvement of the score going, however, by a category of sufficient adherence to MD (4-5: A good start, but you can do better), to the next still better (6-7: You’re doing well) Conclusions: a healthy lifestyle is a cornerstone for reducing cardiovascular mortality and morbidity. A comprehensive CR OP, when the training sessions are associated with educational intervention, can improve, permanently, the level of PA after ACS. Since the atherosclerosis is a process that develops over the years improvements in lifestyle can have a positive impact only if sustained. The minor impact on dietary habits could be explained by the already good adherence to the MD at the beginning of the OP, and for the absence, in the CR team, of the dietitian. A program of CR with a limited follow-up is an effective and low cost tool to promote a healthy lifestyle after an ACS.

Living with a green ligth in the bedroom

Background: Heart failure is a common chronic condition that affects patients’ life situation and puts high demands on self-care and patient participation. Patients often need advanced care due to ...

Health related quality of life, anxiety and depression differs significantly between cardiac diagnostic groups at hospital discharge: results from denheart, a large scale national survey

Background: Heart failure is a common chronic condition that affects patients’ life situation and puts high demands on self-care and patient participation. Patients often need advanced care due to ...

Living with a green ligth in the bedroom: remote monitoring of patients with implantable cardioverter defribrillator

Background: Heart failure is a common chronic condition that affects patients’ life situation and puts high demands on self-care and patient participation. Patients often need advanced care due to ...

To be or not to be tilted

Background: Heart failure is a common chronic condition that affects patients’ life situation and puts high demands on self-care and patient participation. Patients often need advanced care due to ...

To be or not to be tilted: improved care for patients with vasovagal syncope tendencies

Background: Heart failure is a common chronic condition that affects patients’ life situation and puts high demands on self-care and patient participation. Patients often need advanced care due to ...

High protein diet for patients with heart failure

Purpose: Approximately 10 000 people in Sweden suffer from sudden cardiac arrest outside the hospital each year. Cardiopulmonary resuscitation (CPR) is started in about half of the cases. Treatment ...Background: Chest pain is one of the most common reasons for hospital admissions and more than 50 % of the patients admitted are diagnosed as non-cardiac and discharged without a clear explanation ...The purpose was to investigate how a negative life event (NLE) affects perceived psychosocial stress, recovery and running economy (RE). Competitive runners were monitored in a prospective non-experimental cohort study over one full training season in which they experienced the same unplanned severe NLE. Sixteen runners recorded stress and recovery scores (RESTQ-Sport) every week. The average scores over 3 weeks before the NLE were used as a baseline and were compared to scores during the week of the NLE (week 0), week 1and week 2. Seven runners completed a submaximal treadmill test before and after the NLE. Repeated measures ANOVA’s revealed that most scores on general stress scales were increased in week 0 and 1. Of the general recovery scales, “general well-being” was decreased in week 0 and 1, “social” and “physical recovery” were decreased in week 0. No changes in the sport-specific stress scales were found. However, two of the sport-specific recovery scales were decreased in week 0. An impaired RE was shown 3 weeks after the NLE. Therefore, it is important to know what is going on in an athlete’s life, because stressful life events alter RE after the stress and recovery already returned to normal levels.

Living with an ICD-recipient

Purpose: Approximately 10 000 people in Sweden suffer from sudden cardiac arrest outside the hospital each year. Cardiopulmonary resuscitation (CPR) is started in about half of the cases. Treatment ...Background: Chest pain is one of the most common reasons for hospital admissions and more than 50 % of the patients admitted are diagnosed as non-cardiac and discharged without a clear explanation ...The purpose was to investigate how a negative life event (NLE) affects perceived psychosocial stress, recovery and running economy (RE). Competitive runners were monitored in a prospective non-experimental cohort study over one full training season in which they experienced the same unplanned severe NLE. Sixteen runners recorded stress and recovery scores (RESTQ-Sport) every week. The average scores over 3 weeks before the NLE were used as a baseline and were compared to scores during the week of the NLE (week 0), week 1and week 2. Seven runners completed a submaximal treadmill test before and after the NLE. Repeated measures ANOVA’s revealed that most scores on general stress scales were increased in week 0 and 1. Of the general recovery scales, “general well-being” was decreased in week 0 and 1, “social” and “physical recovery” were decreased in week 0. No changes in the sport-specific stress scales were found. However, two of the sport-specific recovery scales were decreased in week 0. An impaired RE was shown 3 weeks after the NLE. Therefore, it is important to know what is going on in an athlete’s life, because stressful life events alter RE after the stress and recovery already returned to normal levels.