The Bavarian Alternative Screening for Atrial Fibrillation (eBRAVE-AF) trial based on eHealth asked older adult members of a German health insurer to use a smartphone app that measured pulse irregularities using the phone’s camera button and then wear a 14-day sunscreen. electrocardiogram patch, in order to engage patients at risk to seek medical treatment.
BECAUSE IT IS IMPORTANT
Afib is the most common heart rhythm disorder and is often difficult to diagnose due to a lack of symptoms.
While previous studies tested the potential of smart devices for Afib screening on a large scale, they did not make any comparisons with conventional screening: symptom assessment, ECG and other methods, according to the announcement of the European Society of Cardiology.
The eBRAVE-AF investigators invited adults aged 50 to 90 years and older who were at risk of stroke but had not experienced any major adverse cardiac or cerebrovascular events and who owned smartphones to participate.
They had no known atrial fibrillation, no oral anticoagulant prescriptions, and a CHA2DS2-VASc score (a scoring methodology based on various factors that would increase the risk of stroke) of ≥1 men and ≥2 women.
Participants had a median age of 65 years and 31% were women.
The number newly diagnosed with atrial fibrillation during the study, which led independent physicians to prescribe oral anticoagulants, occurred in 38 of 2,860 participants assigned to smartphone screening and 17 of 2,691 who participated in conventional screening, according to the researchers’ presentation on August 28. at the ESC Congress.
The Jena, Germany-based Preventicus Heartbeats smartphone app, which claims an overall accuracy of 96%, was used in the study to measure pulse wave irregularities using the photoplethysmographic sensor on the patient’s smartphone, or PPG.
To start a one-minute PPG measurement, the participants placed their fingers on the smartphone camera. The researchers asked digital assessment participants, and sent reminders, to measure PPG twice a day for 14 days, then twice a week.
If the PPG results were abnormal, the researchers sent participants a 14-day ECG recording patch and returned it by mail. The researchers evaluated the ECGs and sent the results to the participants to discuss with their individual physicians, who made treatment decisions.
After six months, the participants switched study groups.
For the secondary analysis, atrial fibrillation, PPG-detected atrial fibrillation, and abnormal PPG findings significantly predicted conditions conducive to stroke, heart failure, or other cardiac problems.
“Screening with common smartphones significantly increased the detection rate of therapy-relevant atrial fibrillation,” Professor Axel Bauer of the Medical University of Innsbruck, Austria, with several affiliations, including the LMU University Hospital in Munich, said in a statement. .
The study was better received by older patients.
THE BIGGEST TREND
Several studies have turned to digital health devices to study their use in delivering effective cardiovascular care and found problems with compromise: getting patients to follow up on Afib device alerts and triggering potentially unnecessary health care visits .
In 2020, the seminal Apple Heart Study with more than 420,000 participants (25,000 over 65 years old) validated the role of Apple Watch in detecting Afibbut the researchers had problems with engagement in general.
Once the algorithm running in the background detected an irregularity and a pulse consistent with AFib, it sent an alert for the participant to press a button on the Apple Watch to enter a signal for a study visit with a doctor.
About 2,200 participants received such notifications, but only 945 of them followed up with a visit, prompting those researchers to ponder how to make a solution that is generalizable.
Then last year, a study published in the Journal of the American Medical Association found that using a device could increase the chance that a patient will undergo an ablation procedure.
Those researchers found no difference in clinic-measured pulse rates between patients with wearables and the control group, just higher rates of health care use among people who used wearables.
IN THE REGISTRY
“This trial focused on a target population for atrial fibrillation screening, rather than all attendees. We found that digital testing was well received by older participants, who tended to take even more PPG measurements than older participants. younger participants in the study,” Bauer said in the statement.
Andrea Fox is a senior editor for Healthcare IT News.
Healthcare IT News is published by HIMSS.