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Remote AF Screening by Patients Boosts Detection: REHEARSE-AF

 Atrial-fibrillation screening via submission of ECGs recorded using a handheld device substantially increases the detection rate of AF compared with routine care, a new study suggests. The results, from a randomized, controlled trial, could pave the way for further use of such devices in the community.

Asking patients to submit readings twice weekly taken on a handheld ECG device (Kardia Mobile, AliveCor) that submits traces over the internet, the researchers were able to quadruple the selection rate of AF over routine primary care.

The research indicated that patients were extremely satisfied with using the devices and reported lower AF anxiety than other patients.

Prof Julian Halcox (Swansea University, Wales) said that this method of AF screening easily could be incorporated into routine clinical practice. Technologies such as these, alongside other systems for screening patients for AF currently under investigation, are addressing a common issue faced by clinicians. We see quite a lot of patients with stroke that looks like it could have been of embolic origin, and we simply cannot identify any rhythm disturbance in any means of monitoring that can help us decide on whether to put the patient on anticoagulation or not.

This is "a heavy decision, since oral anticoagulation done at the therapeutic level does have a risk of bleeding, and so you feel much more comfortable as a physician to do this when you have an appropriate reason to do it,"- said Carlos Manuel Tavares Aguiar (Hospital de Santa Cruz, Lisbon, Portugal), who was not involved in the study,

The study was presented at the European Society of Cardiology 2017 Congress and published simultaneously in Circulation. 

 

Halcox JPJ, Wareham K, Cardew A, et al. Assessment of remote heart rhythm sampling using the AliveCor heart monitor to screen for atrial fibrillation: The REHEARSE-AF study. Circulation2017; DOI:10.1161/CIRCULATIONAHA.117.030583. Article

 

http://www.medscape.com/viewarticle/885031