Abnormal heart rhythm identified in 1 in 20 older adults using wrist-worn wearables and smartphones

Consumer electronics offer a new way to screen for atrial arrhythmias. One study offered continuous smartphone and wearable arrhythmia screening to older adults without known atrial fibrillation. Atrial arrhythmia was detected in five percent of participants. The study was carried out by AFNET. The principal investigator was Professor Larissa Fabritz, University of Birmingham and University Medical Center Hamburg Eppendorf (UKE), Hamburg, Germany.

Atrial fibrillation (AF) is the most common arrhythmia and a growing epidemic. It affects several million people in Europe, mainly the elderly. In many people, arrhythmia is asymptomatic and often goes unnoticed for a long time. This can be dangerous because the risk of stroke and other complications can be high in older people with atrial arrhythmias, even if the arrhythmia only appears temporarily and is not noticed by the affected person. .

Rapid detection of atrial arrhythmias potentially allows earlier treatment to prevent complications, for example by starting anticoagulation to prevent strokes. Thus, experts advise screening in the elderly population in order to systematically search for arrhythmias. Modern smartphone-bound wearables offer a new avenue for this.

The Smart in OAC—AFNET 9 (Smartphone and wearable detect atrial arrhythmia in Older Adults Case Finding) study offered continuous screening for atrial arrhythmia to people over the age of 65 without known atrial fibrillation and not receiving anticoagulation oral. The study was carried out in Germany, Poland and Spain during the COVID pandemic in 2021. 882 elderly people between the ages of 65 and 90 participated and recorded signals.

Professor Fabritz explained the background to the study: “Simple and scalable methods to identify atrial arrhythmias in at-risk populations are needed to enable rapid detection of AF and initiation of treatment. Therefore, we performed the Smart in OAC—AFNET 9 study and evaluated the ease of use of an all-digital detection system for atrial arrhythmias in the elderly.”

Seniors were invited to participate in different ways. The majority of participants were reached through media campaigns in newspapers and television or through word of mouth and town hall meetings for seniors. The other participants were attracted by leaflets, identified by general practitioners aware of the study, a website, outpatient clinics or pharmacies.

Participants received a wristband with a sensor to detect the pulse paired with an app on their smartphone, enabling continuous rhythm monitoring entirely remotely for up to eight weeks. Remote participation was essential in light of the COVID-19 pandemic.

Atrial arrhythmia was detected in 44 participants (5%) within 28 days. Atrial arrhythmia detection was higher during the first week of monitoring compared to subsequent weeks. Only in a few people did the arrhythmia occur for the first time after more than four weeks.

Professor Fabritz concluded: “Smart in OAC—AFNET 9 has successfully used a smartphone and wearable system to detect atrial arrhythmias in elderly people in several European countries. Offers of remote technical support were accepted and compliance was high, showing feasibility for this age group. .”

“Our screening identified atrial arrhythmias in 5% of older adults. Detection rates were high during the first week of monitoring and declined thereafter, suggesting that relatively short monitoring periods may be sufficient to detect older people with atrial arrhythmias These results encourage the use of fully digital systems based on consumer electronics to screen for atrial arrhythmias in unselected older people.

Provided by Competence Network for Atrial Fibrillation eV (AFNET)