Home-based care in post-discharge arrhythmia management: a review

Authors

  • Prafulla Kerkar Department of Cardiology, Asian Heart Institute, Mumbai, Maharashtra, India
  • S. Harikrishnan Department of Cardiology, SCTIMST, Trivandrum, Kerala, India
  • J. P. S. Sawhney Department of Cardiology, Sir Ganga Ram Hospital, Delhi, India
  • Aditya Kapoor Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • Chetan Gharat Medical Affairs, Lupin Digital Health Limited, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20252062

Keywords:

Atrial fibrillation, Rehospitalization, Workbook, Dietary guidelines, Follow-up procedures, Care-pathways

Abstract

Arrhythmia, particularly atrial fibrillation (AF), is a common heart rhythm abnormality with risk factors including age, high blood pressure, alcohol consumption, congenital heart disease, and lung disease. Proper management is critical to prevent complications, enhance quality of life, enable early detection, and reduce healthcare costs. Multidisciplinary patient care and routine follow-up are essential for improving adherence, reducing hospital readmissions, and boosting survival rates. Home-based care has proven to be as effective as clinical settings in reducing mortality and rehospitalization rates. However, challenges such as cost, accessibility, safety, cost, and regulatory issues persist. A comprehensive workbook, including care pathways, dietary guidelines, exercise recommendations, and follow-up procedures, is essential for supporting home care providers and enhancing patient outcomes. A thorough literature review was conducted across multiple databases, including PubMed, Google Scholar, Scopus, and Web of Science, to identify studies related to arrhythmia and home-based post-discharge care. Data from these studies were analyzed and summarized in this review article and highlighted the importance of incorporating home-based care into post-discharge arrhythmia management.

Metrics

Metrics Loading ...

References

Desai DS, Hajouli S. Arrhythmias. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2023.

Vora A, Naik A, Lokhandwala Y, Chopra A, Varma J, Wander G, et al. Profiling cardiac arrhythmia and heart failure patients in India: The Pan-arrhythmia and heart failure observational study. Indian Heart J. 2017;69(2):226-39. DOI: https://doi.org/10.1016/j.ihj.2016.11.329

CDC. About Atrial Fibrillation. Available at: https://www.cdc.gov/heart-disease/about/atrial-fibrillation.html. Accessed on 22 October 2025.

Nesheiwat Z, Goyal A, Jagtap M. Atrial Fibrillation. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing 2023.

Sharma AK, Singh S, Bhat M, Gill K, Zaid M, Kumar S, et al. New drug discovery of cardiac anti-arrhythmic drugs: insights in animal models. Sci Rep. 2023;13(1):16420. DOI: https://doi.org/10.1038/s41598-023-41942-4

Jaarsma T, Larsen T, Strömberg A. Practical guide on home health in heart failure patients. Int J Integr Care. 2013;13:e043. DOI: https://doi.org/10.5334/ijic.992

Deshwal C. Home healthcare in India-Need and future prospects. Glob J Res Anal. 2019;8(2):129-32.

Kaushik A, Patel S, Dubey K. Digital cardiovascular care in COVID-19 pandemic: A potential alternative? J Card Surg. 2020;35(12):3545-50. DOI: https://doi.org/10.1111/jocs.15094

Ellenbecker CH, Samia L, Cushman MJ, Alster K, Hughes RG. Patient safety and quality in home health care. In: Hughes RG, ed. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US). 2008.

Naik N, Yadav R, Juneja R. Epidemiology of arrhythmias in India: How do we obtain reliable data? Curr Sci. 2009;97(3):411-5.

Murakoshi N, Aonuma K. Epidemiology of arrhythmias and sudden cardiac death in Asia. Circ J. 2013;77(10):2419-31. DOI: https://doi.org/10.1253/circj.CJ-13-1129

Hygriv Rao B. Epidemiological data on heart rhythm disorders in India-A formidable but surmountable challenge. Indian Pacing Electrophysiol J. 2012;12(2):37-8. DOI: https://doi.org/10.1016/S0972-6292(16)30478-8

Bohra V, Sharma G, Juneja R. Burden of atrial fibrillation in India. J Prim Care Specialties. 2015;1(3):230-2. DOI: https://doi.org/10.4103/2395-5414.177228

Shah MJ, Bhatt NR, Dabhi A, Thorat PB, Chudasama K, Patel J, et al., A study of 100 cases of arrhythmias in first week of acute myocardial infarction (AMI) in Gujarat: A high risk and previously undocumented population. J. Clin. Diagn. Res. 2014; 8(1): 58-61.

Patel HM, Joshi H. A study of 100 cases of arrythmias in first week of acute myocardial infarction. Paripex Indian J Res. 2020;9(10). DOI: https://doi.org/10.36106/paripex/1602896

Mithun R, Rekha MC. A prospective study of risk of arrythmias in patients with myocardial infarction in a tertiary care center. J Assoc Physicians India. 2022;70(4):11-2.

Yadav SS, Jadhav SM. Detection of common risk factors for diagnosis of cardiac arrhythmia using machine learning algorithm. Expert Systems With Applications. 2020;163(15):113807. DOI: https://doi.org/10.1016/j.eswa.2020.113807

Sai Manoj PD, Jantsch A, Shafique M. Computer-aided arrhythmia diagnosis with bio-signal processing: A survey of trends and techniques. ACM Computing Surveys. 2019;52(2). DOI: https://doi.org/10.1145/3297711

Shrivastav M, Padte S, Arora V, Biffi M. Pilot evaluation of an integrated monitor-adhesive patch for long-term cardiac arrhythmia detection in India. Expert Rev Cardiovasc Ther. 2014;12(1):25-35. DOI: https://doi.org/10.1586/14779072.2013.867807

Desai U, Martis RJ, Nayak CG, Sarika K, Seshikala G. Machine intelligent diagnosis of ECG for arrhythmia classification using DWT, ICA and SVM techniques. 2015 Annual IEEE India Conference (INDICON), New Delhi, India. 2015;1-4. DOI: https://doi.org/10.1109/INDICON.2015.7443220

Yadav S, Kadam V, Jadhav SM. Machine learning algorithms for the diagnosis of cardiac arrhythmia in IoT Environment. In Book: Recent Trends in Image Processing and Pattern Recognition. 2021;1-13. DOI: https://doi.org/10.1007/978-981-16-0493-5_9

Kingma J, Simard C, Drolet B. Overview of cardiac arrhythmias and treatment strategies. Pharmaceuticals (Basel). 2023;16(6):844. DOI: https://doi.org/10.3390/ph16060844

Ball J, Carrington MJ, Thompson DR, Horowitz JD, Stewart S; Standard versus Atrial Fibrillation spEcific managemenT studY Investigators. Post-discharge electrocardiogram Holter monitoring in recently hospitalised individuals with chronic atrial fibrillation to enhance therapeutic monitoring and identify potentially predictive phenotypes. Eur J Cardiovasc Nurs. 2015;14(5):384-94. DOI: https://doi.org/10.1177/1474515114547650

Shrivastav M, Shrivastav R, Makkar J, Biffi M. Patient selection for ambulatory cardiac monitoring in the Indian healthcare environment. Heart Asia. 2013;5(1):112-9. DOI: https://doi.org/10.1136/heartasia-2012-010228

Cioffi G, Mureddu G, Cemin C, Russo TE, Pellegrini A, Terrasi F, et al. Characterization of post-discharge atrial fibrillation following open-heart surgery in uncomplicated patients referred to an early rehabilitation program. Ital Heart J. 2001;2(7):519-28.

Thoren E, Hellgren L, Stahle E. High incidence of atrial fibrillation after coronary surgery. Interact Cardiovasc Thorac Surg. 2016;22(2):176-80. DOI: https://doi.org/10.1093/icvts/ivv326

Lowres N, Mulcahy G, Jin K, Gallagher R, Neubeck L, Freedman B. Incidence of postoperative atrial fibrillation recurrence in patients discharged in sinus rhythm after cardiac surgery: a systematic review and meta-analysis. Interact Cardiovasc Thorac Surg. 2018;26(3):504-11. DOI: https://doi.org/10.1093/icvts/ivx348

Sheikh AB, Felzer JR, Munir AB, Morin DP, Lavie CJ. Evaluating the benefits of home-based management of atrial fibrillation: current perspectives. Pragmat Obs Res. 2016;7:41-53. DOI: https://doi.org/10.2147/POR.S96670

Matteucci A, Bonanni M, Centioni M, Zanin F, Geuna F, Massaro G, et al. Home management of heart failure and arrhythmias in patients with cardiac devices during pandemic. J Clin Med. 2021;10(8):1618. DOI: https://doi.org/10.3390/jcm10081618

Ricci RP, Morichelli L, Santini M. Home monitoring remote control of pacemaker and implantable cardioverter defibrillator patients in clinical practice: impact on medical management and health-care resource utilization. Europace. 2008;10(2):164-70. DOI: https://doi.org/10.1093/europace/eum289

Siaplaouras S, Buob A, Neuberger HR, Mewis C. Remote detection of incessant slow VT with an ICD capable of home monitoring. Europace. 2006;8(7):512-4. DOI: https://doi.org/10.1093/europace/eul050

Varma N, Cygankiewicz I, Turakhia M, Heidbuchel H, Hu Y, Chen LY, et al. ISHNE/HRS/EHRA/ APHRS collaborative statement on mHealth in arrhythmia management: Digital medical tools for heart rhythm professionals. J Arrhythmia. 2021;37(2):271-319. DOI: https://doi.org/10.1002/joa3.12461

Sinclair AJ, Conroy SP, Davies M, Bayer AJ. Post-discharge home-based support for older cardiac patients: A randomised controlled trial. Age Ageing. 2005;34(4):338-43. DOI: https://doi.org/10.1093/ageing/afi116

Pherson EC, Shermock KM, Efird LE, Gilmore VT, Nesbit T, LeBlanc Y, et al. Development and implementation of a postdischarge home-based medication management service. Am J Health-Syst Pharm. 2014;71(18):1576-83. DOI: https://doi.org/10.2146/ajhp130764

Chadda KD, Harrington D, Kushnik H, Bodenheimer MM. The impact of transtelephonic documentation of arrhythmia on morbidity and mortality rate in sudden death survivors. Am Heart J. 1986;112(6):1159-65. DOI: https://doi.org/10.1016/0002-8703(86)90344-3

Storz MA, Helle P. Atrial fibrillation risk factor management with a plant-based diet: A review. J Arrhythm. 2019;35(6):781-8. DOI: https://doi.org/10.1002/joa3.12254

Manolis AS, Manolis TA, Manolis AA, Melita H. Diet and Sudden Death: How to Reduce the Risk. Curr Vasc Pharmacol. 2022;20(5):383-408. DOI: https://doi.org/10.2174/1570161120666220621090343

Nishimura M, Hsu JC. Dietary considerations for the prevention and treatment of arrhythmia. In Book: Prevention and Treatment of Cardiovascular Disease. 2021;265-71. DOI: https://doi.org/10.1007/978-3-030-78177-4_17

McLennan PL, Abeywardena MY, Charnock JS. Dietary fish oil prevents ventricular fibrillation following coronary artery occlusion and reperfusion. Am Heart J. 1988;116(3):709-17. DOI: https://doi.org/10.1016/0002-8703(88)90328-6

Parsi E, Bitterlich N, Winkelmann A, Rosler D, Metzner C. Dietary intervention with a specific micronutrient combination for the treatment of patients with cardiac arrhythmias: the impact on insulin resistance and left ventricular function. BMC Cardiovasc Disord. 2018;18(1):220. DOI: https://doi.org/10.1186/s12872-018-0954-6

Fletcher GF, Chiaramida AJ, LeMay MR, Johnston BL, Thiel JE, Spratlin MC, et al. Telephonically-monitored home exercise early after coronary artery bypass surgery. Chest. 1984;86(2):198-202. DOI: https://doi.org/10.1378/chest.86.2.198

Avila A, Claes J, Buys R, Azzawi M, Vanhees L, Cornelissen V, et al. Home-based exercise with telemonitoring guidance in patients with coronary artery disease: Does it improve long-term physical fitness? Eur J Prev Cardiol. 2020;27(4):367-77. DOI: https://doi.org/10.1177/2047487319892201

Palshikar AA, Gharat C, Patel K. Assessing the effectiveness of software driven digital therapeutics in patients with coronary artery disease or post coronary intervention: real-world evidence study. Int J Adv Med. 2024;11(3):210-8. DOI: https://doi.org/10.18203/2349-3933.ijam20241015

Potdar A, Gharat C, Patel K. Comparing effects of smartphone application based standard of care vs. Standard of care in acute coronary syndrome and coronary artery disease patients: A real-world study. J Clin Exp Cardiolog. 2024;15:890.

Kleinpell RM, Avitall B. Integrating telehealth as a strategy for patient management after discharge for cardiac surgery: results of a pilot study. J Cardiovasc Nurs. 2007;22(1):38-42. DOI: https://doi.org/10.1097/00005082-200701000-00006

Fasing K, Lathkar-Pradhan S, Bray K. Telemedicine: enabling patients with arrhythmias in self-care behaviors. Clin Case Rep Open Access. 2020;3(3):166. DOI: https://doi.org/10.46527/2582-5038.166

Wong E, Xie J, Rajakariar K, Masman K, Mekel J, Nadurata V, et al. The use of telemedicine and remote monitoring for managing patients with implantable cardiac devices at risk of significant cardiac arrhythmias is a safe alternative to face-to-face reviews during the COVID-19 era. Heart Lung Circ. 2021;30:S170. DOI: https://doi.org/10.1016/j.hlc.2021.06.174

Potdar A, Gharat C, Patel K, Chougule N. Evaluation of the effectiveness of an individualized smartphone application-based standard of care versus standard care in CAD and/or ACS patients who underwent PCI: A real-world evidence prospective study. J Res Dev. 2024;12:277.

Scalvini S, Mazzu M, Giordano A, Zanelli E. A review of seven years' telecardiology experience. J Telemed Telecare. 2007;13(5):50-2. DOI: https://doi.org/10.1258/135763307781644997

Fuenzalida C, Hernandez G, Ferro I, Siches C, Ambros A, Coll-Vinent B, et al. Long-term benefits of education by emergency care nurses at discharge of patients with atrial fibrillation. Int Emerg Nurs. 2017;35:7-12. DOI: https://doi.org/10.1016/j.ienj.2017.03.006

Inostroza CIF, Ricart IF, Cuadra CS, Ribo AA, Sánchez MS, Cabrera J, et al. An educational nursing intervention at emergency discharge reduces complications and short-term admissions in patients with atrial fibrillation. Emergencies: J Spanish Soc Emerg Med. 2015;27(2):75-81.

Palshikar A, Gharat CH, Patel K. A real-world evidence study to evaluate the efficacy of software-driven digital therapeutics on major adverse cardiovascular events, vitals, adherence to medication and lifestyle changes among patients with coronary artery disease or post-coronary interventions. Int J Res Med Sci. 2023;11:1541-8. DOI: https://doi.org/10.18203/2320-6012.ijrms20231037

Gupta P, Randhawa S, Nandraj S. The Home Healthcare Boom: Opportunities and obstacles in India’s changing healthcare landscape. Home Health Care Management Practice. 2023;10(10). DOI: https://doi.org/10.1177/10848223231196301

Vinayagamoorthy V, Suguna E, Dongre AR. Evaluation of Community-based Palliative Care Services: Perspectives from Various Stakeholders. Indian J Palliat Care. 2017;23(4):425-30. DOI: https://doi.org/10.4103/IJPC.IJPC_80_17

Downloads

Published

2025-06-27

How to Cite

Kerkar, P., Harikrishnan, S., Sawhney, J. P. S., Kapoor, A., & Gharat, C. (2025). Home-based care in post-discharge arrhythmia management: a review. International Journal of Research in Medical Sciences, 13(7), 3142–3148. https://doi.org/10.18203/2320-6012.ijrms20252062

Issue

Section

Review Articles