The electronic health-based Bavarian Alternative Detection of Atrial Fibrillation (eBRAVE-AF) trial asked older adult members of a German health insurance company to use a smartphone app that measured arrhythmia using a phone’s camera button and then wear 14 days ECG patch to engage at-risk patients to seek treatment from a physician.
why does it matter
AFib is the most common arrhythmia and is often difficult to diagnose due to a lack of symptoms.
While previous studies have tested the capabilities of smart devices to screen Afib on a large scale, they have not been compared to traditional screening – symptom assessment, Electrocardiography and other methods – according to the declaration of the European Society of Cardiology.
eBRAVE-AF researchers invited adults aged 50 to 90 who were at high risk of stroke but had not experienced any major cardiovascular events and who possessed smartphones to participate.
Participants had no known atrial fibrillation, did not have oral anticoagulant prescriptions and a CHA2DS2-VASc score (a The scoring methodology is based on several factors that would increase the risk of stroke) in 1 men and 2 in women.
The average age of the participants was 65 years and they were 31% female.
38 out of 2,860 participants assigned to the smartphone examination and 17 out of 2,691 participants took the traditional examination He was newly diagnosed with Afib during the study, which led to independent doctors prescribing oral anticoagulants, according to a presentation the researchers gave August 28 at the ESC conference.
The German-based Preventicus Heartbeats smartphone app, which claims an overall accuracy of 96%, was used in the study to measure pulse wave irregularities using the patient’s smartphone photoacoustic sensor, or PPG.
To start the 1-minute PPG measurement, participants placed their fingers on the smartphone camera. The researchers asked the digital exam participants—and sent reminders—to measure their PPG twice daily for 14 days, then twice each week.
If the PPG results were abnormal, the researchers then sent the participants a patch to record the 14-day EKG and mail it back. The researchers evaluated the ECG and sent the results back to the participants to speak with their individual physicians, who made treatment decisions.
Six months later, the participants switched study groups.
for secondary analysis, Atrial fibrillation, PPG-detected atrial fibrillation and abnormal results of PPG were significantly predictive of the mature conditions of stroke, heart failure, or other heart problems.
“Screening using common smartphones has significantly increased the detection rate of treatment-related atrial fibrillation,” Professor Axel Bauer of the Medical University of Innsbruck in Austria, with many affiliations including the LMU Hospital in Munich, said in a statement.
Older patients received the study well.
Several studies have turned to digital health devices to study their use in providing effective cardiovascular care and encountered problems with participation – getting patients to follow up on Afib device alerts as well as triggering potentially unnecessary health care visits.
In 2020, Apple’s basic cardiac study was conducted With over 420,000 participants (25,000 over the age of 65) Validating Apple Watch’s Role in Afib Detectionbut researchers generally struggled with participation.
Once the algorithm running in the background detects an irregular and consistent pulse with AFib, it will send an alert to the participant to press a single button on the Apple Watch to get a signal for a study visit with a doctor.
About 2,200 participants received such notifications, but only 945 of them went on to visit, prompting these researchers to think about how to come up with a generalizable solution.
Then last year, a study was published in The Journal of the American Medical Association found it Wearing the device may increase the patient’s risk of undergoing ablation.
These researchers found no difference in pulse rates measured in the clinic between wearable patients and the control group, only higher healthcare use rates among individuals who used the wearables.
“This trial focused on the target population for atrial fibrillation screening, rather than all comers. We found that digital screening was well accepted by older participants, who tended to take PPG measurements more often than younger study participants,” Bauer said in the statement.
Andrea Fox is Senior Editor at Healthcare IT News.
Healthcare IT News is a HIMSS publication.