Digital AF pathway
You have been diagnosed with Atrial Fibrillation (AF), which is a disturbance of your heart rhythm.
We would like you to monitor your heart rate, heart rhythm and symptoms at home over the next one to two weeks using the FibriCheck app on your smartphone, with support from our Remote Monitoring Hub.
The aims of this plan are:
- To ensure your medications are best optimised for your atrial fibrillation
- To better manage any symptoms
- To detect any changes in your condition that may warrant earlier medical attention
- To support and educate you regarding your condition
SETUP
Step 1:
Register onto the Care Information Exchange + share your health record
You will first need to register your email onto the Care Information Exchange (CIE), which is your patient health record platform. All measurements and inputs from the FibriCheck app on your smartphone will be uploaded onto CIE via the cloud.
Please scan the following QR code to enable you to share your health record with the Remote Monitoring Team:
Step 2:
Add the Atrial Fibrillation Care Plan to your profile. The Atrial Fibrillation Care Plan is a record of your heart rate and rhythm measurements as well as your reported symptoms. You can access this at any time and it will also be used by the Remote Monitoring Team to review your entries from the FibriCheck app.
The Atrial Fibrillation Care Plan also includes reference materials about your condition, frequently asked questions, important contact information and our traffic light system (RED-AMBER-GREEN), which will provide you with further guidance on what you should do depending on your heart rate or symptoms.
Step 3: Download and activate FibriCheck
Download the FibriCheck app on your smartphone (via the Apple App Store or Google Play Store). You should register onto the FibriCheck platform by creating an account. You will need to provide an email address, which should be the same as the email address used for registering onto the Care Information Exchange.
FibriCheck can then be activated using your invitation code or the QR code on the patient flyer that has been provided. This can be done inside the app when prompted.
Step 4: Connect FibriCheck to “Patient Knows Best” inside the FibriCheck app
This setting must be toggled to ensure that measurements taken from the FibriCheck app are uploaded onto the Care Information Exchange.
Go to “Settings” and tap on “Connected apps”. Then select “Patient Knows Best”. Tick the box to share your FibriCheck account with Patient Knows Best. You will then be prompted to login to Care Information Exchange. Then tap “Back to app” and then “Open in FibriCheck” to start measuring.
Please take a measurement at least twice a day for seven consecutive days. You may be asked by a member of the remote monitoring team to continue taking measurements for up to 14 days.
All measurements should be taken while you are resting or sat down. Your first daily measurement should ideally be performed between 09:00 and 10:00 and your second daily measurement between 16:00 and 18:00. This will enable the remote monitoring team to review your measurements and symptom entries in a timely manner.
You may wish to record additional measurements outside of these times, such as if you are experiencing symptoms, but they may not be reviewed until the following day. Please refer to advice in the RED-AMBER-GREEN section for further support about what to do if you notice any changes in your symptoms.
Who can I contact for further support?
The remote monitoring hub can be contacted between 9am-7pm daily (including weekends and bank holidays) for assistance, support and to discuss any other concerns. They can be contacted directly on the following number: 07385950852.
A member of the team will contact you following your visit to the Ambulatory Emergency Care (AEC) Unit to provide guidance, support and any troubleshooting assistance.
If your heart rate is too high or too low, or you have “RED FLAG” symptoms, you will be contacted by our remote monitoring team. In this case, you may be asked to attend either the AEC Unit or the emergency department depending on how unwell you are deemed to be.
You may also be contacted by the remote monitoring hub if you miss several measurements for further support.
What will happen after your remote monitoring period?
A member of the team will contact you at the end of the remote monitoring period to advise you on your ongoing care.
The team will review the information you provide and if needed, you may have a future appointment with a cardiologist and additional tests.
If your heart rate and symptoms are well-controlled, you will be discharged back to your GP provided you have no symptoms of concern
If your heart rate is not well-controlled, you may have an appointment to be reviewed in the AEC Unit and/or be referred to the cardiology clinic to have additional tests organised.
Green
Please continue to monitor your heart rate and heart rhythm twice daily on the FibriCheck App for at least one week. Please also monitor for any change in your symptoms. These can be inputted into the App after you have taken a measurement.
Your heart rate should be between 60 and 110. You are asymptomatic. You do not experience any:
- breathlessness
- chest pain
- dizziness
- black outs
- You may experience occasional palpitations but you feel well and these are not uncomfortable for you.
Amber- Keep watch
Please continue to monitor your heart rate and heart rhythm twice daily on the FibriCheck App for 2 weeks. Please also monitor for any changes in your symptoms, and ensure these are entered into the FibriCheck App once you have taken a measurement.
Your heart rate is between 50-60 or between 110-120 for two or more readings and for all other readings between 60 and 110, and you have any of the below symptoms:
You are no more breathless than at the time of your initial Ambulatory Emergency Care (AEC) appointment. You may have experienced palpitations, dizzy spells or mild chest pain.
- You have not had any blackouts
- You may have not developed severe or incapacitating dizziness.
You will be contacted by the Remote Monitoring team in-hours (09:00 -19:00) who will assess you and discuss any concerns with your medical team.
Following an assessment from the Remote Monitoring Team, you may be contacted by a member of the Ambulatory Emergency Care (AEC) team to organise a review of your symptoms, heart rate control and medications. Depending on your symptoms, you may be referred for a cardiology opinion to consider alternative treatments.
The Remote Monitoring Team can be contacted directly for advice between 09:00 and 19:00 via the telephone number in the contact information section.
RED- Take action
Your heart rate was below 50 or above 120 or you have had any of the below symptoms:
- Your breathlessness is worse than your initial Ambulatory Emergency Care (AEC) appointment.
- Your usual exercise capacity is limited because you are getting breathless.
- You have had an episode of moderate or severe chest pain
- you have had a black out
- You have experienced severe or incapacitating dizziness
What should i do?
Please contact the Remote Monitoring Team in-hours (09:00-19:00) who will assess you and discuss any concerns with your medical team. The Remote Monitoring Team may also contact you directly in-hours to assess you. You may be asked to attend either the AEC Unit or the emergency department depending on how unwell you are deemed to be. You may be referred for a cardiology opinion to consider alternative treatments.
Out of hours, consider urgent advice from your GP or 111 if you have any of the highlighted red flag symptoms.
If you feel unwell at any time or are having on-going severe chest pain, severe breathlessness, severe dizziness, or have had a blackout. Go directly to your nearest emergency department or call 999.
Contact Information:
Remote Monitoring Team: 07385950852
Out of hours: Contact 111 or in an emergency call 999