General introduction 13 tertiary referral hospital, has a wider adherence area than other hospitals and referred patients are at risk for a gap in their follow-up. Use of eHealth may facilitate a reduction of patient time spent in clinical assessments, and reduced travel times (31). Early recognition of complications may also be possible using telemedicine. In our clinical practice we offer teleconsultation for our patients until their first outpatient clinic visit. In this thesis we evaluated the feasibility of patient initiated mobile phone photography in assessing a possible complication. 1.4 Aims and outline of this thesis This thesis has two aims: First, to focus on various strategies on reducing complication rates in electrophysiology procedures (part I and II). Secondly, to improve patient empowerment via the use of eHealth innovations with a focus on prevention, identifying and early reduction of complications (part III). In the first part of this thesis (chapters 2 - 4) the focus will be on evaluating the complication rates in ECV and catheter ablation of AF in the Erasmus MC after changes in anticoagulant regimen, but also identifying the proportion of patients with sleep apnoea after catheter ablation of AF. The second part of this thesis (chapters 5 - 7) focuses on evaluating the complication rates in device therapy. We focused on identifying complication rates in CIED therapy. We explored thromboembolic and bleeding complications in CIED related surgery procedures, being implantation, device change or upgrade, but also in a novel lead extraction technique. Furthermore, we evaluated the use of the PADIT score in identifying patients at risk for infection. In the third part of this thesis (chapters 8 and 9), the development of an eHealth and mHealth intervention by the nurse practitioner as a discharge aid in our center is being explored. Both interventions may have furthered patient participation and empowerment. Finally, in chapter 10, the main results of the previous chapters are integrated and interpreted in the summary and final discussion focusing on the clinical implications of the presented studies and directions for future research. 1
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