Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia leading to a five-fold increased risk of stroke. Timely detection of AF is important for the initiation of appropriate therapy and the prevention of adverse outcomes such as AF-related stroke. The aim of this pilot study was to assess the use of a photoplethysmography (PPG)-deriving smartphone application (app) for early detection of AF and initiation of appropriate treatment to avoid AF-related complications such as stroke (1,2).
Patients and Methods: Participants were instructed to perform heart rhythm measurements twice daily and when experiencing symptoms for 7 days using a PPG-deriving smartphone application. All participants with possible AF based on the results of the PPG-deriving app were invited for a confirmatory 24h Holter electrocardiogram (ECG).
Results: A total of 201 patients participated in the study with a mean age of 54 years, ranging from 40 to 84 years. In total, 55% of the population was male, and the AF prevalence was 5.47% (male n= 6; age 61.7±5.3). All patients with possible AF based on the PPG measurements were confirmed on 24h Holter ECG. There were 3 patients without previously diagnosed AF. Nine patients (82%) were known with hypertension, five (45%) suffered from heart failure, and 7 (64%) were on anticoagulation therapy. One patient with AF had already a stroke. The thromboembolic risk evaluated with the CHA2DS2-VASc score was high in participants with AF (score ≥2). In this pilot study, the prevalence of AF was higher among participants with lower levels of education.
Conclusion: The use of smartphone-based technologies for the detection of AF has proven to be an effective way of screening the population for this heart rhythm, as all patients with a positive result based on the 7-day screening were confirmed via the 24-hour Holter ECG. Although this is a small pilot study, the results indicate that the number of patients with AF is higher in relation to available statistical data and date from everyday medical practice. PPG-deriving technologies enable remote AF detection and may contribute to timely initiation of appropriate treatments to avoid complications such as AF-related strokes. One of the major advantages of this approach is the fact that physicians can remotely screen and follow-up patients at risk without the need for face-to-face contacts.