JMIR Cardio最新文献

{"title":"Validity of Heart Rate Measurement Using Wearable Devices During Cardiopulmonary Exercise Testing in Patients With Cardiovascular Disease: Prospective Pilot Validation Study.","authors":"Kazufumi Kitagaki, Yuji Hongo, Rie Futai, Takeshi Hasegawa, Hiroshi Morikawa, Hisashi Shimoyama","doi":"10.2196/77911","DOIUrl":"https://doi.org/10.2196/77911","url":null,"abstract":"<p><strong>Background: </strong>Wearable devices offer a promising solution for remotely monitoring heart rate (HR) during home-based cardiac rehabilitation. However, evidence regarding their accuracy across varying exercise intensities and patient profiles remains limited, particularly in populations with cardiovascular disease (CVD) such as those with heart failure (HF).</p><p><strong>Objective: </strong>The objective of this study was to evaluate the accuracy of HR measurements obtained using the Fitbit Inspire 3 during cardiopulmonary exercise testing (CPX) in patients with CVD, including those with HF.</p><p><strong>Methods: </strong>In this single-center, prospective pilot study, we enrolled 30 patients with CVD undergoing CPX. HR was simultaneously recorded using electrocardiography and the Fitbit Inspire 3 at 1-minute intervals across various CPX phases: rest, exercise below and above the anaerobic threshold (AT), and recovery. The correlation between the two methods was assessed using the Pearson correlation coefficient. Measurement error was quantified by mean absolute error and mean absolute percentage error (MAPE), with a MAPE of ≤10% defined as the threshold for acceptable agreement.</p><p><strong>Results: </strong>All data points were 630 points per minute. The Fitbit Inspire 3 device demonstrated a strong overall correlation with electrocardiography-derived HR (r=0.90; IQR 0.88-0.91) and an acceptable MAPE of 5.40% (SD 8.33%). The total error was 14.9% (94/630), with overestimation and underestimation of 37 (5.8%) points and 57 (9%) points, respectively. The rate of HR underestimation reached 19 (16%) points during exercise above the AT, compared to 1 (3%) point at rest. When stratified by HF stage (B vs C), underestimation was more pronounced in patients with HF (14/275, 5% points vs 40/355, 11.2% points).</p><p><strong>Conclusions: </strong>The Fitbit Inspire 3 provides acceptable validity for HR monitoring during CPX in patients with CVD. However, clinicians should interpret HR data with caution during high-intensity exercise, especially in patients with HF.</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"9 ","pages":"e77911"},"PeriodicalIF":2.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of a Medically Certified, Wrist-Worn Sensor for the Assessment of Heart Rate and Energy Expenditure During Daily Activities in Patients With Chronic Heart Failure or Coronary Artery Disease and Recreational Athletes: Validation Study.","authors":"Ignace L J De Lathauwer, Valerie A A van Es, Mayke M C J van Leunen, Steven Onkelinx, Rutger W M Brouwers, Danny A J P van de Sande, Mathias Funk, Hareld M C Kemps","doi":"10.2196/69343","DOIUrl":"10.2196/69343","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Exercise capacity and lifestyle have proven to be important prognostic factors for cardiovascular patients. Both can be ameliorated through different preventive interventions. Cardiac rehabilitation and remote patient monitoring have been proven to reduce cardiac events and cardiovascular mortality. One of the most important goals of cardiac rehabilitation and remote patient monitoring is improving physical fitness and monitoring of cardiovascular parameters, which could predict cardiac deterioration. In order to monitor cardiac patients successfully, reliable and nonobtrusive devices to assess physical activity and cardiovascular parameters need to be available.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This validation study aims to determine the accuracy of the Philips Health Band (PHB), a noninvasive, wrist-worn, medically certified device, for the assessment of heart rate (HR) and energy expenditure (EE) in patients with chronic cardiovascular diseases and recreational athletes (RAs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The assessment of HR and EE by the PHB was compared with indirect calorimetry (Oxycon Mobile [OM; CareFusion GmbH]) during an activity protocol consisting of daily activities. Three groups were assessed: patients with heart failure with reduced ejection fraction (HFrEF), patients with stable coronary artery disease (CAD) with preserved left ventricular ejection fraction, and RAs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 57 patients were included: 19 with CAD, 19 with HFrEF, and 19 RAs. HR assessment in the HFrEF and CAD groups was significantly underestimated over the entire protocol by the PHB as compared to the OM, with poor and fair reliability, respectively. No significant difference in HR was found between the PHB and OM over the entire protocol for the RA group, with good reliability (HFrEF: mean difference 3.0; P&lt;.001; intraclass correlation coefficient [ICC] 0.36; CAD: mean difference 2.7; P&lt;.001; ICC 0.55; RA: mean difference 0.8; ICC 0.60). Assessment of EE showed an underestimation over the entire protocol for the RA and CAD group, with poor and fair reliability, respectively. The HFrEF group showed no significant difference in EE assessment over the entire protocol, with poor reliability (HFrEF: mean difference 0.09; ICC 0.32; CAD: mean difference 0.29; P&lt;.001; ICC 0.46; RA: mean difference 0.79; P&lt;.001; ICC 0.26). The responsiveness to detect within-patient changes in activity intensity of the PHB was moderate for the HFrEF and CAD groups and acceptable for the RA group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;HR and EE assessment of a medically certified noninvasive sensor using a photoplethysmogram and accelerometer showed poor accuracy and moderate responsiveness during an activity protocol reflecting daily living activities in patients with stable CAD and chronic HFrEF. Accuracy of HR in RAs was good and the responsiveness for both HR and EE was acceptable. This research confirms previous res","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"9 ","pages":"e69343"},"PeriodicalIF":2.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serial 12-Lead ECG-Based Deep-Learning Model for Hospital Admission Prediction in Emergency Department Cardiac Presentations: Retrospective Cohort Study.","authors":"Arda Altintepe, Kutsev Bengisu Ozyoruk","doi":"10.2196/80569","DOIUrl":"https://doi.org/10.2196/80569","url":null,"abstract":"<p><strong>Background: </strong>Emergency Department (ED) crowding is often attributed to a slow hospitalization process, leading to reduced quality of care. Predicting early disposition with cardiac-presenting patients is challenging: most are ultimately discharged, yet those with a cardiac etiology frequently require hospital admission. Existing scores rely on single-time-point data and often underperform when patient risk evolves during the visit.</p><p><strong>Objective: </strong>To develop and validate a real-time deep-learning model that fuses serial 12-lead electrocardiogram (ECG) waveforms with sequential vitals and routinely available clinical data to predict hospital admission early in ED encounters.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the MIMIC-IV, MIMIC-IV-ED, and MIMIC-IV-ECG databases. Adults presenting with chest pain, dyspnea, syncope, or presyncope and at least one ECG within their ED stay were included. Two evaluation cohorts were defined: all stays with ≥1 ECG (N=30,421) and a subset with ≥2 ECGs during the encounter (N=11,273). To predict hospital admission, we first established two baseline models: a tabular model (random forest) trained on structured clinical variables including demographics, triage acuity, past medical history, medications, and laboratory results, and an ECG-only model that learned directly from raw 12-lead waveforms. We then developed a multimodal deep-learning model that combined ECGs with sequential vital signs as well as the same static tabular features. All models were restricted to data available during the stay up to the time of the last ECG. Performance was assessed with stratified 5-fold cross-validation using identical splits across models.</p><p><strong>Results: </strong>The multimodal model achieved an Area Under Receiver Operating Characteristic (AUROC) of 0.911 when trained on all eligible stays. The model predicted disposition after the final ECG was taken, which was a median of 0.3 hours after triage and 4.6 hours before ED departure. Baseline models performed worse: the ECG-only model had an AUROC of 0.852, and the tabular random forest had an AUROC of 0.886. In the subset requiring at least two ECGs within the stay, ECG-only reached an AUROC of 0.859, and random forest, with the longer interval to chart tabular data, reached a higher AUROC of 0.911. The multimodal model had AUROC 0.924, and outperformed baselines in each cohort (paired DeLong P<.001).</p><p><strong>Conclusions: </strong>Serial ECGs, when integrated with evolving vitals and routine clinical features, enable accurate, early prediction of ED disposition in cardiac-presenting patients. This open-source, reproducible framework highlights the potential of multimodal deep learning to streamline ED flow, prioritize higher-risk cases, and detect evolving, time-critical pathology.</p><p><strong>Clinicaltrial: </strong></p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daily Dietary Sodium Intake Among Clinical Trial Participants Recruited From a University Health System or a Federally Qualified Health Center: Secondary Analysis of Baseline Participant Characteristics.","authors":"Gabriella V Rubick, Michael P Dorsch, Scott L Hummel, Tanima Basu, Evan Luff, Kimberly Warden, Michael Giacalone, Sarah Bailey, Mark W Newman, Lesli E Skolarus, Brahmajee K Nallamothu, Jessica R Golbus","doi":"10.2196/71343","DOIUrl":"10.2196/71343","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Efforts to improve diversity in clinical trials often prioritize recruitment based on broad demographic factors. This approach may overlook the influence of community context and health-related social needs on health behaviors, including sodium intake, a key modifiable risk factor for hypertension and cardiovascular disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to assess the impact of enrollment site, sociodemographic factors, and health-related social needs on baseline dietary sodium intake among participants in a mobile health clinical trial aimed at lowering blood pressure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The myBPmyLife study is a prospective, randomized controlled trial evaluating a mobile health intervention to lower blood pressure through increased physical activity and lower sodium food choices. Participants with hypertension were recruited from a university health system and a federally qualified health center (FQHC). All participants completed a validated sodium screener at enrollment. Sociodemographic data and health-related social needs were self-reported. Univariable and multivariable linear regression models were used to evaluate the associations between sodium intake and participant characteristics. This analysis presents a cross-sectional examination of the baseline characteristics of participants enrolled in the myBPmyLife study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 600 included participants, 96 (16.0%) were from the FQHC. Mean age was 60.1 (SD 13.5) years; 48.2% (289/600) were women, and 13.0% (78/600) were Black. FQHC participants were significantly younger (mean age 47.9, SD 11.1 vs 62.5, SD 12.7 years), more likely to be Black (43/96, 44.8% vs 35/504, 6.9%), and 8.5 times more likely to have difficulty paying for their health-related social needs. Mean baseline sodium intake was 3082.3 (SD 1072.5) mg/day, with 85.5% (513/600) of participants exceeding the World Health Organization's recommended daily sodium limit. Baseline sodium intake was significantly higher for FQHC participants (mean difference 381.1, SD 1064.2 mg/d; 95% CI 84.5-677.7; P=.01), men (mean difference 543.9, SD 1038.3 mg/d; 95% CI 377.3-710.5; P&lt;.001), Black participants (mean difference 442.5, SD 1043.4 mg/d; 95% CI 119.7-765.3; P=.008) and those with difficulty affording basic needs (mean difference 338.1, SD 1066.7 mg/d; 95% CI 95.2-581.0; P=.02). Sodium intake was lower in older participants (-196.4 mg/d per 10 years; 95% CI -258.0 to -134.9; P&lt;.001). In a multivariable analysis, age, gender, and race remained independently associated with sodium intake, while differences by site and health-related social needs were not statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Differences in sodium intake were observed across sociodemographic groups. While the enrollment site was not independently associated with sodium intake after adjustment, it played a role in shaping the participant population, evide","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"9 ","pages":"e71343"},"PeriodicalIF":2.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Feasibility and Outcomes of a Digital Health Program to Improve Liver Fat and Cardiometabolic Markers in Individuals With Nonalcoholic Fatty Liver Disease: Prospective Single-Arm Feasibility Study.","authors":"Sigridur Björnsdottir, Hildigunnur Ulfsdottir, Elias Freyr Gudmundsson, Bartosz Dobies, Kolbrun Sveinsdottir, Ari Pall Isberg, Gudlaug E A Magnusdottir, Thrudur Gunnarsdottir, Tekla Karlsdottir, Gudlaug Bjornsdottir, Sigurdur Sigurdsson, Saemundur Oddsson, Vilmundur Gudnason","doi":"10.2196/72074","DOIUrl":"10.2196/72074","url":null,"abstract":"<p><strong>Background: </strong>A 12-week digital health program for nonalcoholic fatty liver disease (NAFLD) previously showed feasibility in engagement, program retention, and clinical outcomes. This study investigates whether improvements in cardiometabolic risk factors achieved during a 12-week active program were sustained over a subsequent 6-month follow-up period.</p><p><strong>Objective: </strong>The primary objective of this analysis was to evaluate whether the clinical improvements achieved after a 12-week program were maintained over the subsequent 6-month period, which did not include coaching or new intervention materials. In addition, the study aimed to assess participants' retention and engagement with the maintenance program.</p><p><strong>Methods: </strong>In a 9-month, single-arm study using the Sidekick app (Sidekick Health), individuals with NAFLD and BMI >30 or metabolic syndrome or type 2 diabetes were included. The initial 12 weeks focused on providing education about diet, physical activity, stress management, and sleep, followed by 6 months without coaching or new intervention materials. The measured outcomes encompassed demographics, body composition, liver fat assessed using magnetic resonance imaging-proton density fat fraction (MRI-PDFF), and blood markers.</p><p><strong>Results: </strong>Of the 34 participants who completed the first 12 weeks, 28 (82%) completed the 9-month study measurements. The median age was 63.0 years (IQR 53.5-71.0) and 57.1% (16/28) were women. At 9 months, compared to baseline, the mean weight loss was 4.0 kg (SD 5.0; P<.001). Liver fat decreased by 2.5% (SD 4.5; P<.001), with an 18.4% relative reduction. Systolic blood pressure decreased by 8.3 mm Hg (SD 13.4, P<.001) and diastolic by 2.5 mm Hg (SD 6.0; P=.02). Waist circumference decreased by 4.7 cm (SD 7.1; P<.001) and median glycated hemoglobin A1c (HbA1c) decreased by 19.5 mmol/mol (P<.001).</p><p><strong>Conclusions: </strong>Sustained improvements in liver fat and metabolic markers suggest that Sidekick Health's digital program is a promising strategy for managing NAFLD without requiring continuous coaching.</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"9 ","pages":"e72074"},"PeriodicalIF":2.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Discharge Planning Videos and Booklets on Quality of Life Among Patients With Heart Failure: Quasi-Experimental Study.","authors":"Fitri Arofiati, Fuji Dwi Lestari, Henri Setiawan","doi":"10.2196/75417","DOIUrl":"10.2196/75417","url":null,"abstract":"<p><strong>Background: </strong>Heart failure remains a major global health issue, significantly impacting patients' quality of life due to its chronic and progressive nature. Effective discharge planning, including educational interventions such as videos and booklets, plays a crucial role in enhancing self-care management and overall patient well-being.</p><p><strong>Objective: </strong>The aim of this study is to evaluate the effects of discharge planning videos and booklets on the quality of life of patients with heart failure.</p><p><strong>Methods: </strong>This study used a quasi-experimental design and was conducted at PKU Muhammadiyah Gamping Hospital from July to November 2024. A total of 42 participants who met the inclusion criteria were selected based on sample size calculations using G*Power and were evenly assigned to intervention and control groups. Both groups received standard discharge planning provided by health care professionals. Discharge planning videos and booklets were developed as educational tools for the intervention group. The Minnesota Living With Heart Failure Questionnaire was used to assess quality of life. The independent sample t test was used to analyze the effect of the intervention using SPSS (version 29). This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and was approved by the institutional review board (number 150/KEP-PKU/VII/2024).</p><p><strong>Results: </strong>The intervention significantly improved the quality of life of patients with heart failure, with the mean score decreasing from 39.00 (SD 8.11) to 24.76 (SD 4.02; P<.001) in the intervention group. In contrast, the control group showed minimal change, from 39.90 (SD 5.89) to 40.24 (SD 5.84), resulting in a statistically significant between-group difference of 15.58 (P<.001). Furthermore, the effect size was large (Cohen d=3.09), suggesting a strong practical significance of the intervention in enhancing the quality of life among patients with heart failure. Moreover, the mean Minnesota Living With Heart Failure Questionnaire scores across 4 domains-physical, mental, emotional, and social-also showed significant improvements after the intervention. The intervention group experienced reductions in all domains: physical (9.95 to 6.76), mental (7.81 to 5.62), emotional (13.19 to 7.48), and social (8.05 to 4.90), whereas the control group showed minimal or no change. These results indicate that the intervention effectively improved patients' quality of life across multiple dimensions.</p><p><strong>Conclusions: </strong>Discharge planning through videos and booklets may improve the quality of life of patients with heart failure compared to standard care. These findings highlight the potential clinical value of structured patient education. The intervention appeared to enhance patients' understanding of their condition and support self-management behaviors, including adherence to lifestyle recom","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"9 ","pages":"e75417"},"PeriodicalIF":2.2,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"English- and Spanish-Speaking Patient Preferences on Home Blood Pressure Monitors in an Urban Safety Net Setting: Qualitative Study.","authors":"Jonathan J Shih, Vivian E Kwok, Isabel Luna, Hyunjin Cindy Kim, Faviola Garcia, Christian Gutierrez, Mahal Garcia, Courtney R Lyles, Elaine C Khoong","doi":"10.2196/60196","DOIUrl":"10.2196/60196","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Self-measured blood pressure monitoring is necessary for successful management of hypertension. However, disparities in blood pressure control persist, with low-income patients and racial and ethnic minorities more likely to have uncontrolled hypertension. These patients are also at increased risk for digital exclusion. Several validated blood pressure monitors for self-measured monitoring are available, but little is known about patient preferences between different device traits. Studies have shown that poor usability or technology design can lead to barriers to adoption.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We investigated patient-reported barriers, preferences, and facilitators to self-measured blood pressure monitoring from a diverse population at an urban safety-net hospital.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This qualitative study included English- and Spanish-speaking patients with hypertension. Participants completed a survey about sociodemographic traits, self-measured blood pressure monitoring practices and training, and experience with technology. Semi-structured interviews were conducted to elicit preferences about blood pressure devices, the accompanying mobile apps, and their experience sharing blood pressure measurements with their providers. Interviews included participant demonstration of home blood pressure measurement to evaluate baseline self-measured blood pressure monitoring technique. Two home blood pressure monitoring devices were presented: a Bluetooth-enabled device and a cellular-enabled device that syncs data directly. Surveys and interviews were conducted in participants' preferred language. Rapid qualitative data analysis was applied to analyze qualitative data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Fifteen participants (8 English-speaking and 7 Spanish-speaking) were enrolled. Participants all identified as racial and ethnic minorities. Educational attainment varied, ranging from less than high school to college graduates. Eight exhibited some form of digital inaccessibility: lacking internet access, not activating their patient portal, or having difficulty connecting a device to Wi-Fi. Most required assistance with Bluetooth pairing and navigating app features. Overall, participants valued tracking their blood pressure, were motivated to engage in self-measured blood pressure monitoring practices, and desired training. Nearly all participants demonstrated inconsistencies in blood pressure education, displayed incorrect measurement techniques, and had not received formal training on self-measured blood pressure monitoring. Spanish-speaking participants reported that using apps was challenging because they were presented in English and wanted translated apps and resources. The cost of features was a key factor in device preference.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Patient-reported barriers to successful self-measured blood pressure monitoring adoption include cost, insufficient training, digi","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"9 ","pages":"e60196"},"PeriodicalIF":2.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"mHealth Support in Cardiac Care Pathways for Patient Self-Management During Transitions From Hospital to Rehabilitation: Exploratory Field Study.","authors":"Isabel Höppchen, Stefan Tino Kulnik, Alexander Meschtscherjakov, Josef Niebauer, Bernhard Reich, Jan David Smeddinck, Daniela Wurhofer","doi":"10.2196/76089","DOIUrl":"https://doi.org/10.2196/76089","url":null,"abstract":"<p><strong>Background: </strong>Cardiac rehabilitation (CR) is essential for recovery from cardiovascular disease. However, patients often encounter challenges in navigating the transition from acute hospital care to CR. Mobile health (mHealth) technologies may support this critical phase; however, evidence regarding their clinical practice remains limited. The HERO app (developed by REDOX GmbH) was developed to address the needs of patients with cardiovascular disease for orientation, emotional support, and motivation during this transition.</p><p><strong>Objective: </strong>This study aims (1) to explore how mHealth technologies tailored for patients with cardiovascular disease can support their needs regarding orientation, emotional balance, and motivation during the transition from the acute hospital to CR and (2) to evaluate the user experience and acceptance of the HERO app as targeted pathway support.</p><p><strong>Methods: </strong>A mixed methods study was conducted with patients with cardiovascular disease using study diaries, questionnaires, and semistructured interviews. Participants were purposively recruited in acute hospitals and rehabilitation settings. Quantitative data were analyzed descriptively, and qualitative data were analyzed using content analysis after Mayring.</p><p><strong>Results: </strong>Eight participants used the app for an average of 14 (range 4-23) days. The app was perceived as a helpful short-term resource. It supported patients in understanding their condition, planning for CR, and regaining motivation. Participants highlighted the value of combining objective information with peer experiences. Suggestions for improvement included more personalized self-management guidance and a precise onboarding process to increase accessibility and usability.</p><p><strong>Conclusions: </strong>Based on the findings, we propose 4 pillars of mHealth support for cardiac care transitions, including timely access, actionable guidance, peer support, and short-term usability. These pillars could inform the design of patient-centered mHealth tools for care transitions.</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"9 ","pages":"e76089"},"PeriodicalIF":2.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12384674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conversational AI Phone Calls to Support Patients With Atrial Fibrillation: Randomized Controlled Trial.","authors":"Ritu Trivedi, Liliana Laranjo, Simone Marschner, Aravinda Thiagalingam, Stuart Thomas, Saurabh Kumar, Tim Shaw, Clara K Chow","doi":"10.2196/64326","DOIUrl":"10.2196/64326","url":null,"abstract":"<p><strong>Background: </strong>Patient education and self-management support are critical for atrial fibrillation (AF) management. Conversational artificial intelligence (AI) has the potential to provide interactive and personalized support, but has not been evaluated in patients with AF.</p><p><strong>Objective: </strong>This study aimed to evaluate the feasibility of a conversational AI intervention to support patients with AF postdischarge.</p><p><strong>Methods: </strong>This was a single-blinded, 4:1-parallel-randomized controlled trial with process evaluation of feasibility and engagement. The primary outcome was the change in Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire total score between groups. Patients with AF (18 y and older) were recruited postdischarge from Westmead Hospital cardiology services and randomized to receive either the intervention or usual care. The 6-month intervention consisted of fully automated conversational AI phone calls (with speech recognition and natural language processing) that regularly assessed patient health and symptoms and provided self-management support and education. These phone calls were supplemented with an online survey (sent via text message or email) containing replicated call content when participants could not be reached after 3 call attempts. If participant responses were concerning (eg, poor overall health, low medication confidence, and high symptom burden), they would be followed up with an ad hoc phone call and directed to clinical care if required. A semipersonalized education website was also available as part of the intervention, and participants were encouraged weekly (nudges delivered via text messages or emails) to visit it.</p><p><strong>Results: </strong>A total of 103 patients (mean age, 63.7 y, SD 11.2 y; n=72, 70% male) were randomized (82 to the intervention); the target sample size was 385. The difference in the AFEQT total score was nonsignificant (adjusted mean difference 2.08, 95% CI -7.79 to 11.96; P=.46). An exploratory prepost comparison revealed an improvement in total AFEQT score in the intervention group only (baseline: 69.9, 95% CI 64.4 to 75.5; 6 months: 79.9, 95% CI 74.9 to 84.8; P=.01). Participants completed 4 of 7 outreaches on average, and 88.4% (304/344) of completed outreaches were reported as useful.</p><p><strong>Conclusions: </strong>This proof-of-concept study demonstrates the feasibility of conversational AI in supporting patients with chronic conditions postdischarge. Intervention participants had improvement in their atrial fibrillation quality of life, though the forced shortening of the evaluation was unable to demonstrate a significant difference between groups.</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"9 ","pages":"e64326"},"PeriodicalIF":2.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Perspectives on the \"Future Patient\" Telerehabilitation Program for Atrial Fibrillation: Qualitative Study.","authors":"Elisabet Dortea Ragnvaldsdóttir Joensen, Andi Eie Albertsen, Helle Spindler, Katja Møller Jensen, Lars Frost, Lars Dittmann, Mathushan Gunasegaram, Søren Paaske Johnsen, Mads Rovsing Jochumsen, Dorthe Svenstrup, Birthe Dinesen","doi":"10.2196/68663","DOIUrl":"10.2196/68663","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a prevalent chronic condition with increasing incidence worldwide. AF increases the risks of stroke, heart failure, and myocardial infarction and imposes a substantial burden on the health care system. Cardiac rehabilitation programs, while effective, often have low patient adherence. Recent evidence suggests that cardiac telerehabilitation, where patients are given home monitoring devices, could enhance adherence and outcomes. The program \"Future Patient-Telerehabilitation of Patients with AF\" (FP-AF) was created to assess the effects and potential benefits of cardiac telerehabilitation on patients with AF.</p><p><strong>Objective: </strong>The objective of this study is to explore the experiences of patients participating in the FP-AF program.</p><p><strong>Methods: </strong>This qualitative sub-study is part of the multicenter, randomized controlled FP-AF trial, which included 208 patients. Semi-structured interviews were conducted on 14 patients, randomly selected from participants in the intervention arm of the FP-AF program. The patient interviews, guided by self-determination theory, focused on patients' experiences with the FP-AF program, including the use of telerehabilitation technologies and a web-based portal called the \"HeartPortal.\" Interview responses were analyzed using NVivo software (version 14.0; QSR International), with thematic coding based on interview guides and methodological guidance elaborated by Brinkmann & Kvale. The study adhered to ethical guidelines, with informed consent obtained from all participants.</p><p><strong>Results: </strong>Based on the interviews, the following themes were identified: the home monitoring devices are viewed positively by the patients; the HeartPortal is a useful digital toolbox; patients develop new coping strategies for living with AF; the measured values are useful for the patients; the community of practice is beneficial; and the FP-AF program creates a sense of security.</p><p><strong>Conclusions: </strong>Participation in the FP-AF program enhanced patients' sense of security, empowerment, and knowledge about AF. This improvement was due largely to a combination of patients' use of the HeartPortal and the educational sessions at health care centers. Telerehabilitation for patients with AF may be a useful way of researching this group of patients with a focus on rehabilitation and may be an effective means of offering rehabilitation to this group in the future.</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"9 ","pages":"e68663"},"PeriodicalIF":2.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}