New research published in the European Heart Journal investigated the long-term effectiveness of a personal ECG (electrocardiogram) device – a device used to check heart rhythm and electrical activity. SAIL Databank was used to evaluate the device over an extended follow-up period in patients at high risk of Atrial fibrillation (AF), a condition that causes an irregular heart rate.
A follow-up of patients who had undergone a 1-year screening programme to detect AF was carried out using electronic health records to see if there were differences in AF diagnoses, strokes, or deaths between those who had the screening device and those who had routine care.
We asked lead researcher, Dr Libby Ellins, to tell us more about the research and its potential implications for health care delivery.
‘We know that people who have the heart rhythm disorder atrial fibrillation (AF), are at increased risk of having a stroke due to an increased risk of blood clots forming in the heart and travelling to the brain. This risk can be reduced by treating patients with anticoagulant (blood thinning) medication. However, people are often unaware that they have AF until they have a stroke. Therefore, it is important to identify those patients who have this condition as early as possible, to facilitate treatment that can reduce their risk of stroke. Various devices are available which allow people to record their heart rhythm at home which can help to detect AF. Previously, we carried out a study that found that using one of these devices (AliveCor Kardia mobile system) twice a week for a year increased the identification of AF with a trend to fewer strokes, when compared with normal routine care. However, this did not tell us whether this benefit extended beyond the year of screening.’
‘The original study recruited patients from the Swansea area, so we could bring their study data into the SAIL databank and linking it anonymously to their health records for an extended period of follow-up time. This allowed us to see whether there were differences in the number of patients identified with AF, strokes and blood clots over a period of just over 4 years.’
‘We found that over the longer-term period of follow-up there was no longer any difference in the number of people identified with AF, nor the number of patients experiencing strokes/blood clots between the two groups. These findings suggested that although a year of proactive screening for AF appears promising, these benefits are not maintained over time after completion of the screening process.’
‘This finding suggests that more work needs to be done to refine the most appropriate approach for AF screening, both in terms of target population and identifying the best ECG monitoring strategy to improve longer-term outcomes in those most at risk of AF.’
Read the full publication here – https://academic.oup.com/ehjopen/article/3/3/oead047/7150879