Mobile applications for atrial fibrillation self-management: A systematic search and evaluation

Atrial fibrillation (AF) is the most common cardiac arrhythmia, increasing the risk of stroke, heart failure, and healthcare costs. Although patient self-management can improve outcomes, sustaining long-term engagement is difficult. Mobile health applications may help address this gap, but their quality and clinical alignment have not been systematically assessed using a validated framework.

This study aimed to systematically identify and evaluate AF self-management applications using the Mobile Application Rating Scale (MARS) and to assess how well these apps align with evidence-based practices for AF.

We conducted a structured search of the Apple App Store and Google Play Store (June 2024, updated January 2025) for English-language, patient-focused apps supporting AF self-management (eg, symptom logging, medication reminders, and educational content). Eligible apps offered ≥1 self-management feature and either explicitly referenced AF or, for general self-management apps, provided features directly applicable to AF self-care. 2 reviewers independently rated app quality using the MARS across 4 domains (Engagement, Functionality, Aesthetics, and Information).

Of the 455 apps identified, 5 met all inclusion criteria. Common features included symptom tracking and medication logging, but coverage of guideline-recommended care domains varied. Mean MARS scores ranged from 4.07 to 4.53 (out of 5). Higher-performing apps excelled in functionality and information quality but often lacked features such as stroke-risk assessment and personalized feedback.

Current AF self-management apps show high MARS quality but lack comprehensive, clinically grounded functionality, highlighting a gap in digital tools for AF self-care. Improved codesign processes and standardized evaluation frameworks may guide development of more effective apps.