Assessment of available online educational resources for patients with atrial fibrillation

Background: A diagnosis of atrial fibrillation (AF) often leads patients to search online for information, which can expose them to information of varied quality. Objective: We conducted a qualitative systematic review of websites that contain useful information regarding AF. Methods: The following terms were searched on 3 search engines (Google/Yahoo/Bing): (Atrial fibrillation for patients), (What is atrial fibrillation), (Atrial fibrillation patient information), (Atrial fibrillation educational resources). Inclusion criteria included websites with comprehensive AF information and information about treatment options. The Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) and PEMAT for Audiovisual Materials assessed understandability and actionability (score range 0–100). Those with a mean PEMAT-P score of .70, meaning acceptable understandability and actionability, underwent DISCERN score assessment of information content quality and reliability (score range 16–80). Results: The search yielded 720 websites that underwent full review. After exclusions, 49 underwent full scoring. The mean overall PEMAT-P score was 69.3 6 17.2. The mean PEMAT-AV score was 63.4 6 13.6. Of the websites that scored .70% on the PEMAT-P, 23 (46%) underwent DISCERN scoring. The mean DISCERN score was 54.7 6 4.6. Conclusions: There is a wide variation in the understandably, actionability, and quality of websites, many not providing patientlevel materials. Knowledge of quality websites could provide an important adjunct for improving patients understanding of AF.Melissa E. Middeldorp, Ellen Lyrtzis, Kyle Heath, Tanya Hall, Kadhim Kadhim, Prashanthan Sander

Rationale and design of the IRON-AF study: a double-blind, randomised, placebo-controlled study to assess the effect of intravenous ferric carboxymaltose in patients with atrial fibrillation and iron deficiency

Introduction: Atrial fibrillation (AF) is associated with significantly impaired quality-of-life. Iron deficiency (ID) is prevalent in patients with AF. Correction of ID in other patient populations with intravenous iron supplementation has been shown to be a safe, convenient and effective way of improving exercise tolerance, fatigue and quality-of-life. The IRON-AF (Effect of Iron Repletion in Atrial Fibrillation) study is designed to assess the effect of iron repletion with intravenous ferric carboxymaltose in patients with AF and ID. Methods and Analysis: The IRON-AF study is a double-blind, randomised controlled trial that will recruit at least 84 patients with AF and ID. Patients will be randomised to receive infusions of either ferric carboxymaltose or placebo, given in repletion and then maintenance doses. The study will have follow-up visits at weeks 4, 8 and 12. The primary endpoint is change in peak oxygen uptake from baseline to week 12, as measured by cardiopulmonary exercise testing (CPET) on a cycle ergometer. Secondary endpoints include changes in quality-of-life and AF disease burden scores, blood parameters, other CPET parameters, transthoracic echocardiogram parameters, 6-minute walk test distance, 7-day Holter/Event monitor burden of AF, health resource utilisation and mortality. Ethics and dissemination: The study protocol has been approved by the Central Adelaide Local Health Network Human Research Ethics Committee, Australia. The results of this study will be disseminated through publications in peer-reviewed journals and conference presentations.Samuel J Tu, Adrian D Elliott, Nicole Hanna-Rivero, Celine Gallagher, Ricardo S Mishima, Ellen Lyrtzis, Danielle Wlochowicz, Nicholas AR Clarke, Kurt C Roberts-Thomson, Michael B Stokes, Mehrdad Emami, Dennis H Lau, Prashanthan Sanders, Christopher X Won

Trajectories in response to Aripiprazole Maintena Study: Six-month follow-up

RANZCP AbstractsSR Clark, KO Schubert, AT Olagunju, E Lyrtzis, D Watson, BT Baun

False remote monitoring alerts from explanted cardiac implantable electronic device: How is this possible?

A 72-year-old woman with a dual-chamber implantable cardioverter-defibrillator (Biotronik Lumax 540 DR-T) at elective replacement indicator presented for generator replacement. A new MicroPort generator (Platinium DR) was attached to her existing leads. Eight days later, multiple red alert messages were received on the Biotronik remote monitoring system from the explanted generator. Investigations revealed alert transmission via a CardioMessenger Smart mobile device registered to another patient that came into proximity of the explanted generator. The Biotronik remote monitoring system is unique in that red alerts could be sent through any CardioMessenger Smart device regardless of whether they were paired.Kyle M.Heath, Ellen Lyrtzis Melissa E.Middeldorp, Prashanthan Sanders, Dennis H.La

Cognitive deficits in the THINC-integrated tool (THINC-it) are associated with psychosocial dysfunction in patients with major depressive disorder

Objective: To evaluate the extent to which cognitive measures in the recently developed THINC-integrated tool (THINC-it) are associated with global and domain specific psychosocial disability in patients with current and remitted major depressive disorder (MDD). Methods: Cross-sectional data (N = 127) were obtained from participants with current (n = 105) or remitted (n = 22) MDD who completed the THINC-it between July 2014 and June 2018. Major depressive disorder was diagnostically assessed with DSM-IV and DSM-5 criteria. The THINC-it includes 4 objective cognitive tests: the Spotter (ie, Choice Reaction Time), Symbol Check (ie, n-back), CodeBreaker (ie, Digit Symbol Substitution), and Trails (ie, Trail Making Test part B), as well as a measure of self-perceived cognitive deficits, the Perceived Deficits Questionnaire for Depression-5-item (PDQ-5-D). Psychosocial dysfunction was assessed with the Functioning Assessment Short Test. Results: The whole group analysis (ie, lifetime MDD) indicated that poor objective cognitive performance on the CodeBreaker (β = 0.346, P = .002) and Trails tasks (β = 0.232, P = .017) and greater self-reported cognitive deficits on the PDQ-5-D (β = 0.596, P < .001) were associated with more severe global psychosocial disability. In addition, performance on the CodeBreaker and Trails tasks showed dissociable relationships with specific psychosocial deficits (eg, occupational functioning, daily autonomy). The relationship between cognitive and psychosocial deficits was stronger in participants with current compared to remitted MDD. Conclusions: Cognitive deficits identified by the THINC-it are associated with global and specific psychosocial deficits, highlighting the clinical value and utility of the THINC-it as a cognitive screening instrument in patients with MDD.Matthew J. Knight, Célia Fourrier, Ellen Lyrtzis, Natalie Aboustate, Emma Sampson, Hikaru Hori, Natalie T. Mills, and Bernhard T. Baun