Structured Rehabilitation for Patients with Atrial Fibrillation Based on an Integrated Care Approach: Protocol for a Prospective, Observational Cohort Study

Figures & data

Figure 1 Flow chart.

Abbreviations: mAFA, mobile Atrial fibrillation Application; LAAO, left atrial appendage occlusion.

Table 1 Structured Follow-Up Rehabilitation Package for AF Patients Not Undergoing Invasive Procedures

	1 m	3 m	6 m	9 m	12 m
Avoid stroke
Dynamic stroke risk monitoring			√		√
Dynamic bleeding risk monitoring	√	√	√	√	√
Anticoagulant quality monitoring	√	√	√	√	√
OAC dosage adjustment	√	√	√	√	√
Safe drug monitoring	√	√	√	√	√
Green channel for TE/bleeding event	√	√	√	√	√
Better symptom control
Symptom control	√	√	√	√	√
Cardiac rhythm management	√	√	√	√	√
AI AF risk prediction	√	√	√	√	√
Antiarrhythmic drug/rate–control drug management (safe monitoring, dosage adjustment)	√	√	√	√	√
Comorbidity management	√	√	√	√	√
Timely communication between doctors and patients	√	√	√	√	√
Patient educational programme	√	√	√	√	√

Abbreviations: OAC, anticoagulant; TE, thromboembolism; AI, artificial intelligence; AF, atrial fibrillation.

Figure 2 Structured follow-up rehabilitation packages. (A) Structured follow-up rehabilitation package for AF patients with drug treatment only. (B) Structured follow-up rehabilitation package for patients undergoing AF ablation. (C) Structured follow-up rehabilitation package for patients undergoing LAAO or LAAO plus ablation.

Abbreviations: mAFA, mobile Atrial fibrillation Application; LAAO, left atrial appendage occlusion; AI, artificial intelligence; AF, atrial fibrillation.

Table 2 Structured Follow-Up Rehabilitation Package for AF Patients with Ablation or LAAO

	1 m	2 m	3 m	6 m	9 m	12 m
Ablation complication monitoring
Atrial-oesophageal fistulas	√
Pulmonary vein stenosis	√	√	√
Symptom and cardiac rhythm control after ablation
Symptom amelioration	√	√	√	√	√	√
Cardiac rhythm/rate monitoring*	√	√	√	√	√	√
Drug management
Antiarrhythmic drug (safe monitoring, dosage-adjustment)	√	√	√	√**	√**	√**
OACs (safe monitoring, dosage-adjustment)	√	√	√**	√**	√**	√**
AF recurrence management
AF recurrence risk assessment	√
AI AF risk prediction	√	√	√	√	√	√
Reduce AF recurrence through cardiovascular risk control	√	√	√	√	√	√
Comorbidity management	√	√	√	√	√	√
Rehabilitation for patients with stroke^^	√	√	√	√	√	√

Notes: *If patients had compatible smart devices. **Depending on patient’s risk profile. ^{^}If patients had a stroke.

Abbreviations: LAAO, left atrial appendage occlusion; OAC, oral anticoagulant; TE, thromboembolism; AI, artificial intelligence; AF, atrial fibrillation.

Table 3 Sample Size Calculation in Relation to ABC Pathway Compliance

Pathway	Compliance (%)	Sample Size (n)	Dropout-Inflated Enrolment*(n)	Dropout-Inflated Enrolment**(n)
A	55.3%	830	913	1039
B	75.1%	1145	1260	1432
C	19.2%	1180	1298	1475
ABC	8.3%	2400	2640	3000

Notes: *The dropout rate was assumed to be 10% in the first year. **The dropout rate was assumed to be 20% in the first year. The sample size was calculated with a power of 80% and 1-A=0.05. The compliance of ABC was cited from the Gulf Survey of Atrial Fibrillation Events Registry (Gumprecht J, et al. J Clin Med 2020). PASS 15 (NCSS, LLC.) was used for the calculation.

Data Sharing Statement

The data used to support the findings of this study are available from the corresponding author upon request.