Atrial fibrillation future clinic. Novel platform to integrate smart device electrocardiogram into clinical practice

Direct-to-consumer devices allow patients to record electrocardiograms (ECG) and detect atrial fibrillation (AF). Clinical adoption of these devices has been limited owing to the lack of efficient workflow.

To assess a new care model for following patients after AF ablation that uses a smartphone ECG coupled with a novel cloud-based platform.

This was a pilot study to describe AF detection, healthcare utilization, use of additional ECGs and cardiac monitors, and changes in anxiety after AF ablation. Patients presenting 3-4 months after early successful AF ablation were randomized into a control group with standard clinical follow-up or a self-monitoring group using smartphone ECG (Kardia Mobile, KM) coupled with a cloud-based platform (KardiaPro, KP) that alerted the physician when AF was detected and followed for 6 months.

A total of 100 patients were randomized: 51 to the KM/KP group and 48 to the control group (1 withdrew). AF was detected in 18 patients (18.2%), 11 (21.6%) in the KM/KP group and 7 (14.6%) in the control group (P = .42). AF detection occurred at a median of 68 and 91 days in the KM/KP and control groups, respectively (P = .93). These differences were not statistically significant. Healthcare utilization and changes in anxiety were similar between the groups. More patients required additional ECGs or cardiac monitors in the control group (27.1%) compared to the KM/KP group (5.9%) (P = .004).

Smartphone ECG with a cloud-based platform can be incorporated into the care of post-AF ablation patients without increasing anxiety and with less need for additional traditional monitors.