Individuals at high risk for atrial fibrillation (AFib) who utilized a home-based wearable electrocardiogram (ECG) patch had a higher rate of AFib diagnosis after four months compared to delayed monitoring, according to new findings from the mHealth Screening to Prevent Strokes (mSToPS) trial published in the Journal of the American Medical Association.
Monitored individuals had higher rates of AFib and greater initiation of anticoagulants. They also had increased healthcare resource utilization after one year.
“For approximately 20 percent of individuals who experience a stroke due to AFib, the occurrence of AFib was not diagnosed until the time of their stroke or shortly afterward,” wrote lead author Steven R. Steinhubl, MD, of Scripps Translational Science Institute, in La Jolla, California, and colleagues. “However, if AFib is recognized, therapeutic anticoagulation can lead to an absolute risk reduction in all strokes of 2.7 percent per year for primary and 8.4 percent per year for secondary prevention, as well as a 0.5 percent per year absolute risk reduction in mortality.”
The researchers sought to determine the efficacy of a self-applied wearable ECG patch has in detecting AFib and the clinical impact of using the patch.
“Opportunistic screening for AFib is recommended, and improved methods of early identification could allow for the initiation of appropriate therapies to prevent the adverse health outcomes associated with AFib,” Steinhubl and colleagues wrote.
The study enrolled 2,659 individuals into the study, who were randomly assigned to immediate or delayed monitoring. Only 65 percent, or 1,738 individuals, in the cohort completed active monitoring, and the control group included 3,400 individuals.
In the randomized study, new incidences of AFib were identified after four months in almost 4 percent of individuals in the immediate monitoring group and less than 1 percent of individuals in the delayed monitoring group.
A year later, AFib was newly diagnosed in 109 monitored and 81 unmonitored individuals. The researchers also found increased initiation of anticoagulants, outpatient cardiology visits and primary care visits associated with active monitoring.
“A new diagnosis of AFib would never be considered a normal finding and, even when asymptomatic, is strongly associated with the development of clinical AFib,” Steinbuhl et al. wrote. “Early recognition could encourage the implementation of strategies to prevent progression, such as treatments of sleep apnea or morbid obesity.”