Remote Design of a Smartphone and Wearable Detected Atrial Arrhythmia in Older Adults Case Finding Study: Smart in OAC - AFNET 9

Larissa Fabritz; D Connolly; E Czarnecki; D Dudek; A Zlahoda-Huzior; E Guasch; D Haase; T Huebner; K Jolly; P Kirchhof; Ulrich Schotten; Antonia Zapf; Renate B Schnabel

doi:10.3389/fcvm.2022.839202

Remote Design of a Smartphone and Wearable Detected Atrial Arrhythmia in Older Adults Case Finding Study: Smart in OAC - AFNET 9

Front Cardiovasc Med. 2022 Mar 21:9:839202. doi: 10.3389/fcvm.2022.839202. eCollection 2022.

Authors

Larissa Fabritz^{1

2

3

4}, D Connolly^{4

5}, E Czarnecki⁶, D Dudek^{7

8}, A Zlahoda-Huzior⁹, E Guasch^{10

11

12}, D Haase⁶, T Huebner¹³, K Jolly¹⁴, P Kirchhof^{2

3

4

6}, Ulrich Schotten^{6

15}, Antonia Zapf¹⁶, Renate B Schnabel^{2

3

6}

Affiliations

¹ University Center of Cardiovascular Science, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
² Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³ German Center for Cardiovascular Research, Partner Site Hamburg/Luebeck/Kiel, Berlin, Germany.
⁴ Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom.
⁵ Department of Cardiology and R&D, Birmingham City Hospital, Sandwell and West Birmingham Trust, Birmingham, United Kingdom.
⁶ Atrial Fibrillation NETwork, Münster, Germany.
⁷ Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
⁸ Maria Cecilia Hospital, GVM Care & Research, Ravennna, Italy.
⁹ Department of Measurement and Electronics, AGH University of Science and Technology, Krakow, Poland.
¹⁰ Institut Clínic Cardio-Vascular, Hospital Clínic, University of Barcelona, Barcelona, Spain.
¹¹ August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain.
¹² Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares, Madrid, Spain.
¹³ Preventicus GmbH, Jena, Germany.
¹⁴ Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.
¹⁵ Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, Netherlands.
¹⁶ Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Abstract

Introduction: Screening for atrial fibrillation and timely initiation of oral anticoagulation, rhythm management, and treatment of concomitant cardiovascular conditions can improve outcomes in high-risk populations. Whether wearables can facilitate screening in older adults is not known.

Methods and analyses: The multicenter, international, investigator-initiated, single-arm case-finding Smartphone and wearable detected atrial arrhythmia in older adults case finding study (Smart in OAC - AFNET 9) evaluates the diagnostic yield of a validated, cloud-based analysis algorithm detecting atrial arrhythmias via a signal acquired by a smartphone-coupled wristband monitoring system in older adults. Unselected participants aged ≥65 years without known atrial fibrillation and not receiving oral anticoagulation are enrolled in three European countries. Participants undergo continuous pulse monitoring using a wristband with a photo plethysmography (PPG) sensor and a telecare analytic service. Participants with PPG-detected atrial arrhythmias will be offered ECG loop monitoring. The study has a virtual design with digital consent and teleconsultations, whilst including hybrid solutions. Primary outcome is the proportion of older adults with newly detected atrial arrhythmias (NCT04579159).

Discussion: Smart in OAC - AFNET 9 will provide information on wearable-based screening for PPG-detected atrial arrhythmias in Europe and provide an estimate of the prevalence of atrial arrhythmias in an unselected population of older adults.

Keywords: atrial fibrillation; digital cardiology; digital consent; photo plethysmography; screening; stroke; telemedicine; wearable.

Associated data

ClinicalTrials.gov/NCT04579159