title: Clinical Usefulness of a Mobile Application for the Appropriate Selection of the Antiarrhythmic Device in Heart Failure.
abstract: BACKGROUND
  Appropriate selection of implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy (CRT) device can be challenging in patients with left ventricular (LV) dysfunction. In this setting, limited information exists about the role of medical applications in helping physicians to choose the most useful device.
  
  
  METHODS
  We developed a medical application that provides guidelines-based algorithms for helping doctors in decision process using the Apache Cordova application programming interface. e-CRTD App was tested in 36 consecutive patients (age 66.4 ± 8.5 years, 31 males) with diagnosis of heart failure (HF) addressed to electrophysiology laboratory for evaluation of ICD (N = 18) or CRT with defibrillator device (CRT-D; N = 18) implantation. Two separate teams evaluated each patient independently: expert electrophysiologists (Group A); cardiologists in training using the App (Group B).
  
  
  RESULTS
  The outcomes of the clinical evaluation performed by Groups A and B were similar in 100% of patients in terms of classes of recommendations to device (Class I in eight cases, Class IIa in seven cases, Class III in the remaining 21). Surprisingly, the majority of indications from the general practitioners to cardiac device were inappropriate (N = 17 ICD, and N = 4 CRT-D, Class III); nevertheless, e-CRTD App helped Group B (nonexpert cardiologists) in excluding all these cases.
  
  
  CONCLUSIONS
  This study describes and validates a mobile application realized to help the decision-making process in HF patients candidate to ICD/CRT-D. This application supports physicians to assess the eligibility for ICD or CRT-D according to current guidelines in patients with LV dysfunction.
authors.affiliation: Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia, Campus di Germaneto, Catanzaro, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Curcio
authors.affiliation: Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia, Campus di Germaneto, Catanzaro, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: DE Rosa
authors.affiliation: Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia, Campus di Germaneto, Catanzaro, Italy.
authors.forename: Jolanda
authors.initials: J
authors.lastname: Sabatino
authors.affiliation: Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia, Campus di Germaneto, Catanzaro, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: DE Luca
authors.affiliation: Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia, Campus di Germaneto, Catanzaro, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Bochicchio
authors.affiliation: Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia, Campus di Germaneto, Catanzaro, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Polimeni
authors.affiliation: Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia, Campus di Germaneto, Catanzaro, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santarpia
authors.affiliation: Institute of Forensic Medicine, University Magna Graecia, Campus di Germaneto, Catanzaro, Italy.
authors.forename: Pietrantonio
authors.initials: P
authors.lastname: Ricci
authors.affiliation: Division of Cardiology, Department of Medical and Surgical Sciences, University Magna Graecia, Campus di Germaneto, Catanzaro, Italy.|U.R.T.-C.N.R, Catanzaro, Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Indolfi
mesh_terms: D000465:Algorithms; D058409:Cardiac Resynchronization Therapy Devices / Q000706:statistics & numerical data; D000066491:Clinical Decision-Making / Q000379:methods*; D020000:Decision Support Systems, Clinical; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D006333:Heart Failure / Q000175:diagnosis / Q000517:prevention & control*; D006801:Humans; D008875:Middle Aged; D063731:Mobile Applications; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013813:Therapy, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome; D014584:User-Computer Interface
keywords: cardiac devices; congestive heart failure; digital medicine; mobile application; risk stratification