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

doi:10.1093/ehjdh/ztac067

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

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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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 language	English
Pages (from-to)	610–625
Number of pages	16
Journal	European Heart Journal - Digital Health
Volume	3
Issue number	4
Early online date	1 Nov 2022
DOIs	https://doi.org/10.1093/ehjdh/ztac067
Publication status	Published - Dec 2022

Keywords

Atrial arrhythmia
Consumer electronics
Elderly population
Early detection
Digital trial

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/ehjdh/ztac067Licence: Creative Commons: Attribution-NonCommercial (CC BY-NC)

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1 Active
2 Finished

A pilot study to assess the safety, effectiveness and practical utility of remote patient monitoring to guide the timing of valve intervention in patients with asymptomatic severe aortic stenosis (APRAISE-AS)
Stubbs, C. (Co-Investigator), Brocklehurst, P. (Principal Investigator), Mehta, S. (Co-Investigator), Fabritz, L. (Co-Investigator), Kyte, D. (Co-Investigator) & Magill, L. (Co-Investigator)
NIHR
18/07/22 → 16/03/25
Project: Other Government Departments
BHF Research Accelerator Award
Bicknell, R. (Co-Investigator), Watson, S. (Co-Investigator), Rainger, E. (Co-Investigator), Senis, Y. (Co-Investigator), Fabritz, L. (Co-Investigator) & Kirchhof, P. (Principal Investigator)
British Heart Foundation
1/04/19 → 30/09/24
Project: Research
H2020_COLLAB_CATCH ME_(LEAD)
Kirchhof, P. (Principal Investigator), Fabritz, L. (Co-Investigator), Hemming, K. (Co-Investigator) & Deeks, J. (Co-Investigator)
European Commission
1/05/15 → 30/04/19
Project: EU

Cite this

Fabritz, L., Connolly, D. L., Czarnecki, E., Dudek, D., Guasch, E., Haase, D., Huebner, T., Zlahoda-Huzior, A., Jolly, K., Kirchhof, P., Obergassel, J., Schotten, U., Vettorazzi, E., Winkelmann, S. J., Zapf, A., & Schnabel, R. B. (2022). Smartphone and wearable detected atrial arrhythmias in older adults: results of a fully digital European case finding study. European Heart Journal - Digital Health, 3(4), 610–625. https://doi.org/10.1093/ehjdh/ztac067

@article{25e20898d5a44bee993c437020a5d302,

title = "Smartphone and wearable detected atrial arrhythmias in older adults: results of a fully digital European case finding study",

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).",

keywords = "Atrial arrhythmia, Consumer electronics, Elderly population, Early detection, Digital trial",

author = "L Fabritz and Connolly, {D L} and E Czarnecki and D Dudek and E Guasch and D Haase and T Huebner and A Zlahoda-Huzior and K Jolly and P Kirchhof and J Obergassel and U Schotten and E Vettorazzi and Winkelmann, {S J} and A Zapf and Schnabel, {R B}",

year = "2022",

month = dec,

doi = "10.1093/ehjdh/ztac067",

language = "English",

volume = "3",

pages = "610–625",

journal = "European Heart Journal - Digital Health",

number = "4",

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Fabritz, L, Connolly, DL, Czarnecki, E, Dudek, D, Guasch, E, Haase, D, Huebner, T, Zlahoda-Huzior, A, Jolly, K , Kirchhof, P, Obergassel, J, Schotten, U, Vettorazzi, E, Winkelmann, SJ, Zapf, A & Schnabel, RB 2022, 'Smartphone and wearable detected atrial arrhythmias in older adults: results of a fully digital European case finding study', European Heart Journal - Digital Health, vol. 3, no. 4, pp. 610–625. https://doi.org/10.1093/ehjdh/ztac067

TY - JOUR

T1 - Smartphone and wearable detected atrial arrhythmias in older adults

T2 - results of a fully digital European case finding study

AU - Fabritz, L

AU - Connolly, D L

AU - Czarnecki, E

AU - Dudek, D

AU - Guasch, E

AU - Haase, D

AU - Huebner, T

AU - Zlahoda-Huzior, A

AU - Jolly, K

AU - Kirchhof, P

AU - Obergassel, J

AU - Schotten, U

AU - Vettorazzi, E

AU - Winkelmann, S J

AU - Zapf, A

AU - Schnabel, R B

PY - 2022/12

Y1 - 2022/12

N2 - 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).

AB - 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).

KW - Atrial arrhythmia

KW - Consumer electronics

KW - Elderly population

KW - Early detection

KW - Digital trial

U2 - 10.1093/ehjdh/ztac067

DO - 10.1093/ehjdh/ztac067

M3 - Article

VL - 3

SP - 610

EP - 625

JO - European Heart Journal - Digital Health

JF - European Heart Journal - Digital Health

IS - 4

ER -

Smartphone and wearable detected atrial arrhythmias in older adults: results of a fully digital European case finding study

Abstract

Keywords

UN SDGs

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Projects

A pilot study to assess the safety, effectiveness and practical utility of remote patient monitoring to guide the timing of valve intervention in patients with asymptomatic severe aortic stenosis (APRAISE-AS)

BHF Research Accelerator Award

H2020_COLLAB_CATCH ME_(LEAD)

Cite this