Screen for AF with consumer wearables

Consumer watches and similar wearables could help find atrial fibrillation in people who do not know they have it. The Apple Heart Study showed that such alerts can be run at very large scale with no clinic visits, and that some alerts match atrial fibrillation on an ECG patch. It did not test whether people who get alerts have fewer strokes, so that question is open.

Idea
In this atlas

Overview

Technical summary

Hypothesis page with maturity set to early feasibility. The Apple Heart Study, which measured how often an alert matched an ECG patch, is the one study read. Its registry lists no stroke or other clinical outcome. The abstract reports that alerts were rare (0.52% of participants), that 34% of notified participants with analyzable patches had atrial fibrillation on the patch, and that 57% of notified participants who answered a survey contacted providers outside the study. No guideline on screening with wearables was read.

Hypothesis

Hypothesis, not a result. Nothing here has been demonstrated.

Alerts from consumer wearables could find atrial fibrillation in people who have no symptoms and no known diagnosis.

Maturity: Early feasibility
Rationale: NHLBI says atrial fibrillation may cause no symptoms at all, which makes it difficult to diagnose. The Apple Heart Study authors say its siteless, pragmatic design provides a foundation for large-scale pragmatic studies in which outcomes or adherence can be reliably assessed with user-owned devices.
Proposed test: A study that follows people who do and do not receive alerts and compares clinical outcomes, with a way to confirm each alert with an ECG. The Apple Heart Study did not do this.

Objections

In the Apple Heart Study, 34% of notified participants who returned an analyzable ECG patch had atrial fibrillation on it, and only 450 of the 2161 notified participants returned analyzable patches.
The registry lists no stroke or other clinical outcome, so the study does not show that alerts prevent strokes.
Of 1376 notified participants who returned a 90-day survey, 57% contacted health care providers outside the study, which is a follow-up burden for people and clinics.

Claims and evidence

No claims are published for this idea yet.

Record details

Record id: cardio:idea-wearable-af-screening
Content hash: a882d9cc61efad44eec9a57cf4cece9ce59917faa94fb707fad91e4d23273c08