Telehealth-Supported Village Doctor-Led Trial for Preventing Heart Failure in Older Rural Patients with Atrial Fibrillation

What This Trial Is About

Researchers are evaluating a telehealth-supported, village doctor-led integrated care program compared to usual care to improve cardiovascular health and prevent heart failure in older adults with atrial fibrillation living in rural China. This study focuses on older patients aged 65 to 80 years without prior heart failure and aims to improve AF management, self-care adherence, and reduce cardiovascular complications over several years. Participants in the intervention group will receive monthly follow-ups by village doctors, symptom and vital sign monitoring, medication support, cardiovascular risk management, guideline-based AF care following the ABC pathway, simplified exercise rehabilitation, and remote specialist consultation via telemedicine. Village doctors will be trained in stroke prevention, anticoagulation, symptom control, and risk factor management. The control group will receive usual chronic disease care according to national public health guidelines without the structured integrated program. Participants will be monitored for up to 7 years, with key assessments at 12, 36, 48, and 84 months. Researchers will track changes in cardiovascular health scores, composite cardiovascular events, new heart failure diagnoses, and adherence to guideline-based AF care. Evaluations include symptom assessments, ECGs, risk factor monitoring, and emergency visits. The study includes long-term follow-up to assess the sustained impact of the intervention on heart failure prevention and cardiovascular outcomes.

A Village Doctor-led Telehealth Supported Trial of Heart Failure Prevention in AF Patients: MIRACLE-AF 2 (Heart Failure Prevention)