A smartphone may be enough to screen for atrial fibrillation on the general population. Thus, after the necessary checks by the doctor, it is possible to begin a treatment that reduces the risk of stroke. Thanks to specific apps to be loaded on the phone, it is possible to double the rate of detection and treatment of rhythm disturbance in older people compared to routine techniques such as pulse assessment or electrocardiogram. Obviously, if the system detects anomalies, the word must go to the doctor, for routine examinations and any treatment of the pathology.
The eBRAVE-Af study, presented at the Congress of the European Society of Cardiology and coordinated by Axel Bauer of the University of Innsbruck. The goal of the research is simple: by being able to identify atrial fibrillation early, which can increase the risk of suffering a stroke up to five times, it is possible to activate an anticoagulant treatment (or any other targeted therapies) that reduce this danger.
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An “intelligent” sensor
The research examined over 5,500 people (average age 65, almost a third women) without any diagnosis of atrial fibrillation or taking anticoagulant drugs.
The participants were divided into two groups: in one they downloaded a certified app on their smartphone that measures the irregularities of the wrist waves thanks to a photoplethysmographic sensor of the phone. The survey was carried out for one minute, twice a day, for two weeks. In case of anomalies, a “virtual” check was then carried out with a patch capable of recording the electrocardiogram.
In the second group, on the other hand, screening was carried out on the basis of symptoms, occasional electrocardiograms and other classical methods. The objective to evaluate the effectiveness of the technology was newly diagnosed atrial fibrillation within six months: the arrhythmia was “flushed out” in 1.33% in the arm using the smartphone against 0.63% in subjects subjected to common screening strategies. Going on beyond six months with a second phase of the study, the superiority of digital screening compared to the classic one was confirmed.
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The doctor governs the situation
“Screening with common smartphones significantly increased the detection rate of atrial fibrillation relevant to therapy – Bauer commented. Importantly, app-based pre-screening was only part of the program, which also included validation of the electrocardiogram and evaluation of the results by an independent physician “.
What matters, however, is to be able to reveal atrial fibrillation as soon as possible. Arrhythmia, by disturbing the normal circulation of blood inside the heart, facilitates the formation of clots that can obstruct the vessels that supply the brain, causing the appearance of cerebral ischemias. Unfortunately, people often do not know they have it and this greatly affects the opportunities for pharmacological intervention.
Ok for wrist devices too
The confirmation of the role of technology in screening also comes from research that simulated what could occur in a population of 30 million over-65s. From the analysis, published in JAMA Health Forum and conducted by Massachusetts General Hospital researchers such as JagPreet Chhatwalit appears that smartwatches and the like are more convenient than traditional electrocardiograms and pulse palpation for screening for atrial fibrillation, potentially reducing the incidence of stroke.
The researchers tested eight screening strategies: six using wrist wearable devices and two using wrist palpation and electrocardiography. The six devices included used two types of technology: either photoplethysmography, which involves the non-invasive use of a light source on the wrist to measure changes in blood volume as a pulse indicator, and electrocardiogram.
The “economically preferred” strategy is the ability to record photoplethysmography with a wrist device, followed by an ECG worn on the wrist accompanied by a more specific rhythm monitoring patch when a possible arrhythmia is reported, to confirm the picture.
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