Background 

Atrial fibrillation (AF) is associated with high recurrence rates and poor health-related quality of life (HRQOL) but few effective interventions to improve HRQOL exist.

Objective 

The aim of this study was to examine the impact of the “iPhone Helping Evaluate Atrial Fibrillation Rhythm through Technology” (iHEART) intervention on HRQOL in patients with AF.

Methods 

We randomized English- and Spanish-speaking adult patients with AF to receive either the iHEART intervention or usual care for 6 months. The iHEART intervention used smartphone-based electrocardiogram monitoring and motivational text messages. Three instruments were used to measure HRQOL: the Atrial Fibrillation Effect on Quality of Life (AFEQT), the 36-item Short-Form Health survey, and the EuroQol-5D. We used linear mixed models to compare the effect of the iHEART intervention on HRQOL, quality-adjusted life-years, and AF symptom severity.

Results 

A total of 238 participants were randomized to the iHEART intervention (n = 115) or usual care (n = 123). Of the participants, 77% were men and 76% were white. More than half (55%) had an AF recurrence. Both arms had improved scores from baseline to follow-up for AFEQT and AF symptom severity scores. The global AFEQT score improved 18.5 and 11.2 points in the intervention and control arms, respectively (P < .05). There were no statistically significant differences in HRQOL, quality-adjusted life-years, or AF symptom severity between groups.

Conclusions 

We found clinically meaningful improvements in AF-specific HRQOL and AF symptom severity for both groups. Additional research with longer follow-up should examine the influence of smartphone-based interventions for AF management on HRQOL and address the unique needs of patients diagnosed with different subtypes of AF.

中文翻译：

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房颤患者的移动心电图监测和与健康相关的生活质量：iPhone 的结果有助于通过技术 (iHEART) 研究评估房颤节律。

背景 

房颤 (AF) 与高复发率和较差的健康相关生活质量(HRQOL)相关，但几乎没有有效的干预措施来改善 HRQOL。

目标 

本研究的目的是检查“iPhone 通过技术帮助评估房颤节律”（iHEART）干预对 AF 患者 HRQOL 的影响。

方法 

我们将讲英语和西班牙语的 AF 成年患者随机分配接受 iHEART 干预或常规护理 6 个月。iHEART 干预使用基于智能手机的心电图监测和激励短信。使用三种仪器测量 HRQOL：房颤对生活质量的影响(AFEQT)、36 项简短健康调查和 EuroQol-5D。我们使用线性混合模型来比较 iHEART 干预对 HRQOL、质量调整生命年和 AF 症状严重程度的影响。

结果 

共有 238 名参与者随机接受 iHEART 干预（n = 115）或常规护理（n = 123）。在参与者中，77% 是男性，76% 是白人。超过一半 (55%) 有房颤复发。从基线到随访，两组的 AFEQT 和 AF 症状严重程度评分都有改善。干预组和对照组的全球 AFEQT 评分分别提高了 18.5 和 11.2 分（P < .05）。两组之间的 HRQOL、质量调整生命年或 AF 症状严重程度没有统计学显着差异。

结论 

我们发现两组的 AF 特异性 HRQOL 和 AF 症状严重程度都有临床意义的改善。具有更长随访时间的其他研究应检查基于智能手机的 AF 管理干预对 HRQOL 的影响，并解决被诊断为不同亚型 AF 的患者的独特需求。