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Smartphone app could be used for atrial fibrillation screening

Smartphone app could be used for atrial fibrillation screening - Featured Image

A smartphone app, combined with a hand-held wireless single lead heart monitor (ECG), could feasibly be used to test for atrial fibrillation (AF).

The method is inexpensive and accessible, making it particularly useful for systematic mass screening given that the condition was silent in around two thirds of newly diagnosed cases, according to research published online in the journal Heart.

The researchers tested more than 13,000 adults in Hong Kong for AF between May 2014 and April 2015 using a smartphone app combined with a hand-held, wireless, single lead heart monitor (ECG).

The test, which lasted 30 seconds, detected up 101 cases (0.8 per cent) of AF that had been previously undiagnosed. In two thirds of these cases, the condition was symptomless, but their combined risk scores topped three, suggesting that they would have benefited from treatment.

The result was uninterpretable in 56 cases (0.4 per cent) of those tested.

Overall, almost one in 10 (8.5 per cent) of those tested had AF—a prevalence that is comparable with that of populations in developed countries. Increasing age, being male, weight, a history of heart disease or surgery, and peripheral vascular disease, were all predictive of the condition.

Current guidelines recommend opportunistic screening for AF, but the researchers wrote that their findings indicated that systematic mass screening might instead be feasible.

“A systematic population-based ECG screening for AF, instead of an opportunistic approach, as recommended by the current (European Society of Cardiology) guidelines, may lead to a reduction in the incidence of stroke in the community,” the research concludes, advocating the need for a well-designed clinical trial to test the technology.

Related: Guidelines for the management of atrial fibrillation released

A linked editorial by Swedish cardiologists Dr Emma Svennberg and Dr Johan Engdahl from the Karolinska Institute and the Sahlgrenska Academy at Gothenburg University respectively agreed that the findings were important, but they remained cautious.

“Systematic mass screening programmes for AF have not achieved coverage of more than 50 per cent when targeted at those most at risk—uptake that is lower than most other established screening programmes,” they wrote.

“Much more data on the optimal mode and duration of ECG recording are needed.”

The iECG, a smartphone app that can detect AF, is currently being trialled in a pilot program in far Western New South Wales to create the first snapshot of rates of the condition among the Indigenous community. The ABC reported on the trial, which is being run by Sydney University’s Poche Centre for Indigenous Health.

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