Smartphone and wearable detected atrial arrhythmias in Older Adults: Results of a fully digital European Case finding study

L Fabritz*, D L Connolly, E Czarnecki, D Dudek, E Guasch, D Haase, T Huebner, A Zlahoda-Huzior, K Jolly, P Kirchhof, J Obergassel, U Schotten, E Vettorazzi, S J Winkelmann, A Zapf, R B Schnabel, Smart in OAC—AFNET 9 investigators

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

AIMS: Simplified detection of atrial arrhythmias via consumer-electronics would enable earlier therapy in at-risk populations. Whether this is feasible and effective in older populations is not known.

METHODS AND RESULTS: The fully remote, investigator-initiated Smartphone and wearable detected atrial arrhythmia in Older Adults Case finding study (Smart in OAC-AFNET 9) digitally enrolled participants ≥65 years without known atrial fibrillation, not receiving oral anticoagulation in Germany, Poland, and Spain for 8 weeks. Participants were invited by media communications and direct contacts. Study procedures adhered to European data protection. Consenting participants received a wristband with a photoplethysmography sensor to be coupled to their smartphone. The primary outcome was the detection of atrial arrhythmias lasting 6 min or longer in the first 4 weeks of monitoring. Eight hundred and eighty-two older persons (age 71 ± 5 years, range 65-90, 500 (57%) women, 414 (47%) hypertension, and 97 (11%) diabetes) recorded signals. Most participants (72%) responded to adverts or word of mouth, leaflets (11%) or general practitioners (9%). Participation was completely remote in 469/882 persons (53%). During the first 4 weeks, participants transmitted PPG signals for 533/696 h (77% of the maximum possible time). Atrial arrhythmias were detected in 44 participants (5%) within 28 days, and in 53 (6%) within 8 weeks. Detection was highest in the first monitoring week [incidence rates: 1st week: 3.4% (95% confidence interval 2.4-4.9); 2nd-4th week: 0.55% (0.33-0.93)].

CONCLUSION: Remote, digitally supported consumer-electronics-based screening is feasible in older European adults and identifies atrial arrhythmias in 5% of participants within 4 weeks of monitoring (NCT04579159).

Original languageEnglish
Pages (from-to)610-625
Number of pages16
JournalEuropean Heart Journal - Digital Health
Volume3
Issue number4
DOIs
Publication statusPublished - Dec 2022

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