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Smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial

Aims: Atrial fibrillation (AF) is a preventable cause of ischaemic stroke but it is often undiagnosed and undertreated. The utility of smartphone electrocardiogram (ECG) for the detection of AF after ischaemic stroke is unknown. The aim of this study is to determine the diagnostic yield of 30-day sm...

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Main Authors: KENG TAT, KOH, WAN CHUNG, LAW, WIN MOE, ZAW, PING FOO, HUI, CHEN TING, TAN, STEVEN, ANDERSON, DESMOND, SAMUEL, TEH LOM, FAM, CHING HUA, TAN, ZHAI SING, WONG, XAVIAR, SIVARAJ, CHANDAN DEEPAK, BHAVNANI, SENG HONG, TAN, YEN YEE, OON, ASRI, SAID, YEAN YIP, FONG, TIONG KIAM, ONG
Format: Article
Language:English
Published: Oxford Academic 2021
Subjects:
RC Internal medicine
Online Access:http://ir.unimas.my/id/eprint/35784/1/smartphone1.pdf
http://ir.unimas.my/id/eprint/35784/
https://academic.oup.com/europace/article-abstract/23/7/1016/6199914?redirectedFrom=fulltext
https://doi.org/10.1093/europace/euab036
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spelling my.unimas.ir.357842021-08-11T06:50:41Z http://ir.unimas.my/id/eprint/35784/ Smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial KENG TAT, KOH WAN CHUNG, LAW WIN MOE, ZAW PING FOO, HUI CHEN TING, TAN STEVEN, ANDERSON DESMOND, SAMUEL TEH LOM, FAM CHING HUA, TAN ZHAI SING, WONG XAVIAR, SIVARAJ CHANDAN DEEPAK, BHAVNANI SENG HONG, TAN YEN YEE, OON ASRI, SAID YEAN YIP, FONG TIONG KIAM, ONG RC Internal medicine Aims: Atrial fibrillation (AF) is a preventable cause of ischaemic stroke but it is often undiagnosed and undertreated. The utility of smartphone electrocardiogram (ECG) for the detection of AF after ischaemic stroke is unknown. The aim of this study is to determine the diagnostic yield of 30-day smartphone ECG recording compared with 24-h Holter monitoring for detecting AF ≥30 s. Methods and results: In this multicentre, open-label study, we randomly assigned 203 participants to undergo one additional 24-h Holter monitoring (control group, n = 98) vs. 30-day smartphone ECG monitoring (intervention group, n = 105) using KardiaMobile (AliveCor®, Mountain View, CA, USA). Major inclusion criteria included age ≥55 years old, without known AF, and ischaemic stroke or transient ischaemic attack (TIA) within the preceding 12 months. Baseline characteristics were similar between the two groups. The index event was ischaemic stroke in 88.5% in the intervention group and 88.8% in the control group (P = 0.852). AF lasting ≥30 s was detected in 10 of 105 patients in the intervention group and 2 of 98 patients in the control group (9.5% vs. 2.0%; absolute difference 7.5%; P = 0.024). The number needed to screen to detect one AF was 13. After the 30-day smartphone monitoring, there was a significantly higher proportion of patients on oral anticoagulation therapy at 3 months compared with baseline in the intervention group (9.5% vs. 0%, P = 0.002). Conclusions: Among patients ≥55 years of age with a recent cryptogenic stroke or TIA, 30-day smartphone ECG recording significantly improved the detection of AF when compared with the standard repeat 24-h Holter monitoring. Keywords: Anticoagulation; Atrial fibrillation; Cryptogenic stroke; Digital health; Smartphone electrocardiogram.f Oxford Academic 2021-07 Article PeerReviewed text en http://ir.unimas.my/id/eprint/35784/1/smartphone1.pdf KENG TAT, KOH and WAN CHUNG, LAW and WIN MOE, ZAW and PING FOO, HUI and CHEN TING, TAN and STEVEN, ANDERSON and DESMOND, SAMUEL and TEH LOM, FAM and CHING HUA, TAN and ZHAI SING, WONG and XAVIAR, SIVARAJ and CHANDAN DEEPAK, BHAVNANI and SENG HONG, TAN and YEN YEE, OON and ASRI, SAID and YEAN YIP, FONG and TIONG KIAM, ONG (2021) Smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial. Europace, 23 (7). pp. 1016-1023. ISSN 1099-5129 https://academic.oup.com/europace/article-abstract/23/7/1016/6199914?redirectedFrom=fulltext https://doi.org/10.1093/europace/euab036
institution Universiti Malaysia Sarawak
building Centre for Academic Information Services (CAIS)
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaysia Sarawak
content_source UNIMAS Institutional Repository
url_provider http://ir.unimas.my/
language English
topic RC Internal medicine
spellingShingle RC Internal medicine
KENG TAT, KOH
WAN CHUNG, LAW
WIN MOE, ZAW
PING FOO, HUI
CHEN TING, TAN
STEVEN, ANDERSON
DESMOND, SAMUEL
TEH LOM, FAM
CHING HUA, TAN
ZHAI SING, WONG
XAVIAR, SIVARAJ
CHANDAN DEEPAK, BHAVNANI
SENG HONG, TAN
YEN YEE, OON
ASRI, SAID
YEAN YIP, FONG
TIONG KIAM, ONG
Smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial
description Aims: Atrial fibrillation (AF) is a preventable cause of ischaemic stroke but it is often undiagnosed and undertreated. The utility of smartphone electrocardiogram (ECG) for the detection of AF after ischaemic stroke is unknown. The aim of this study is to determine the diagnostic yield of 30-day smartphone ECG recording compared with 24-h Holter monitoring for detecting AF ≥30 s. Methods and results: In this multicentre, open-label study, we randomly assigned 203 participants to undergo one additional 24-h Holter monitoring (control group, n = 98) vs. 30-day smartphone ECG monitoring (intervention group, n = 105) using KardiaMobile (AliveCor®, Mountain View, CA, USA). Major inclusion criteria included age ≥55 years old, without known AF, and ischaemic stroke or transient ischaemic attack (TIA) within the preceding 12 months. Baseline characteristics were similar between the two groups. The index event was ischaemic stroke in 88.5% in the intervention group and 88.8% in the control group (P = 0.852). AF lasting ≥30 s was detected in 10 of 105 patients in the intervention group and 2 of 98 patients in the control group (9.5% vs. 2.0%; absolute difference 7.5%; P = 0.024). The number needed to screen to detect one AF was 13. After the 30-day smartphone monitoring, there was a significantly higher proportion of patients on oral anticoagulation therapy at 3 months compared with baseline in the intervention group (9.5% vs. 0%, P = 0.002). Conclusions: Among patients ≥55 years of age with a recent cryptogenic stroke or TIA, 30-day smartphone ECG recording significantly improved the detection of AF when compared with the standard repeat 24-h Holter monitoring. Keywords: Anticoagulation; Atrial fibrillation; Cryptogenic stroke; Digital health; Smartphone electrocardiogram.f
format Article
author KENG TAT, KOH
WAN CHUNG, LAW
WIN MOE, ZAW
PING FOO, HUI
CHEN TING, TAN
STEVEN, ANDERSON
DESMOND, SAMUEL
TEH LOM, FAM
CHING HUA, TAN
ZHAI SING, WONG
XAVIAR, SIVARAJ
CHANDAN DEEPAK, BHAVNANI
SENG HONG, TAN
YEN YEE, OON
ASRI, SAID
YEAN YIP, FONG
TIONG KIAM, ONG
author_facet KENG TAT, KOH
WAN CHUNG, LAW
WIN MOE, ZAW
PING FOO, HUI
CHEN TING, TAN
STEVEN, ANDERSON
DESMOND, SAMUEL
TEH LOM, FAM
CHING HUA, TAN
ZHAI SING, WONG
XAVIAR, SIVARAJ
CHANDAN DEEPAK, BHAVNANI
SENG HONG, TAN
YEN YEE, OON
ASRI, SAID
YEAN YIP, FONG
TIONG KIAM, ONG
author_sort KENG TAT, KOH
title Smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial
title_short Smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial
title_full Smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial
title_fullStr Smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial
title_full_unstemmed Smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial
title_sort smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial
publisher Oxford Academic
publishDate 2021
url http://ir.unimas.my/id/eprint/35784/1/smartphone1.pdf
http://ir.unimas.my/id/eprint/35784/
https://academic.oup.com/europace/article-abstract/23/7/1016/6199914?redirectedFrom=fulltext
https://doi.org/10.1093/europace/euab036
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score 13.211869

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