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Fully digital self-screening for atrial fibrillation with patch electrocardiogram

Edvard Liljedahl Sandberg1, Sigrun Halvorsen2,3, Trygve Berge4

  • 1Department of Cardiology, Sorlandet Hospital, Postboks 416 Lundsiden, 4604 Arendal, Norway.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|March 22, 2023
PubMed

Insights

A fully digital self-screening for atrial fibrillation (AF) using a patch ECG demonstrated excellent feasibility in individuals at risk for stroke. This method detected undetected AF in 2.2% of participants, highlighting its potential for early intervention.

Area of Science:

  • Cardiology
  • Digital Health
  • Public Health Screening

Background:

  • Atrial fibrillation (AF) is a prevalent arrhythmia linked to significant mortality, morbidity, and healthcare costs.
  • Current guidelines advocate for screening individuals at risk for AF, yet optimal methods and organizational structures remain undefined.
  • Early detection of AF is crucial for preventing stroke and other complications.

Purpose of the Study:

  • To evaluate the feasibility of a novel, fully digital self-screening procedure for AF.
  • To determine the prevalence of previously undetected AF in a at-risk population using continuous patch electrocardiogram (ECG) monitoring.
  • To assess the usability and effectiveness of a digital self-screening tool for AF detection.

Main Methods:

  • A fully digital, continuous self-screening for AF was conducted using a patch ECG device (ECG247 Smart Heart Sensor) in individuals aged 65+ with stroke risk factors in Norway.
  • Participants (N=2118) self-reported clinical data and usability online, receiving digital feedback.
  • The study tracked completion rates, monitoring duration, and AF detection rates.

Main Results:

  • The study enrolled 2118 participants (mean age 70.1 years, 74% women) with a mean CHA2DS2-VASc score of 2.6.
  • A high completion rate of 87.3% (1849 participants) was observed for the ECG self-screening test, with a system usability score of 84.5.
  • Atrial fibrillation was detected in 41 individuals (2.2%), indicating a number needed to screen of 45 to identify one unrecognized case.

Conclusions:

  • The fully digitalized self-screening procedure for AF proved to be highly feasible and effective in detecting undiagnosed cases within a population at risk for stroke.
  • The number needed to screen (45) suggests a practical approach for identifying individuals with AF.
  • Further randomized controlled trials with long-term follow-up are warranted to ascertain if this self-screening approach can effectively reduce AF-related complications.
Abstract

Keywords:
Atrial fibrillationDigitalSelf-screening

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