Research
Remote heart rhythm screening increases diagnosis of common heart condition
A wearable electronic patch increases diagnosis of atrial fibrillation, according to research part-funded by us and presented at the European Society of Cardiology Congress in Madrid.
Atrial fibrillation is a common abnormal heart rhythm that causes your heart to beat irregularly and often too fast. People with atrial fibrillation are five times more likely to have a stroke, but the condition often goes undiagnosed. Early detection can allow for timely treatment to reduce stroke risk.
Researchers from the University of Oxford found that using the ECG patches led to a small increase in the number of people who were diagnosed with atrial fibrillation, compared to those who didn’t receive a patch.
The results are published in the Journal of the American Heart Association (JAMA).
Patches in the post
The AMALFI trial involved 5,040 people aged over 65 with risk factors for a stroke. Half were randomly assigned to wear an ECG patch for two weeks in addition to their usual medical care, while the other half continued to receive their usual care without wearing a patch.
Participants in the study received the ECG patches in the post. They were self-applied, and recorded participants’ heart rhythms whilst they went about their normal day-to-day activities. The patches were returned for analysis after 14 days.
After 2.5 years, 172 participants in the ECG patch group (6.8 per cent) had been diagnosed with atrial fibrillation, compared to 136 (5.4 per cent) in the group who received usual medical care only.
People were diagnosed with atrial fibrillation earlier if they had worn the patch, and they were more likely to be prescribed anticoagulants (blood thinning medication), one of the treatment options to reduce their risk of having a stroke.
The researchers found that the burden of atrial fibrillation detected by the patches was often low – meaning that people’s hearts were spending only spending a small amount of time beating in atrial fibrillation and they were perhaps less likely to have a stroke.
Overall, the rate of strokes was similar between the two groups – 69 participants (2.7 per cent) in the group who wore ECG patches and 64 (2.5 per cent) in the usual care group.
'Practical and convenient'
Dr Sonya Babu-Narayan, our Clinical Director and consultant cardiologist, said: “In this study, researchers found that at-home screening for atrial fibrillation, using easy-to-apply ECG patches that can be returned by post, was practical and convenient for older patients, including those living with multiple health conditions. More research is now needed to better understand who may benefit from this type of screening.”
Louise Bowman, Professor of Medicine and Clinical Trials at Oxford Population Health, and one of the study leads, said “Atrial fibrillation can be difficult to detect as it often occurs without symptoms and/or infrequently. New monitoring technology has enabled longer-duration screening which can detect short or infrequent atrial fibrillation episodes which might otherwise be missed.
“AMALFI has shown that it is possible to undertake screening for atrial fibrillation efficiently and with minimal disruption to practice staff and participants, demonstrating that remote clinical trials can assess important health questions. Longer-term and cost-effectiveness analyses of AMALFI are planned and will provide more insight in due course.”