Screening for Atrial Fibrillation

Table of contents

1. Atrial Fibrillation
2. Screening Studies
   1. STROKESTOP Study
   2. STROKESTOP II Study
   3. SAFER Study
   4. LOOP Study
   5. SCREEN-AF Study
   6. REHEARSE-AF Study
   7. PULsE-AI Trial
3. AF Detection Studies
   1. Apple Heart Study
   2. FitBit Heart Study
4. Devices
   1. Zenicor’s handheld ECG device
   2. AliveCor’s Kardia Mobile device
   3. Withings wrist-watch devices
   4. Cardiolund’s ECG Parser algorithm
   5. Context
5. Context
   1. Single-time point screening
   2. ECG-based AF screening
   3. Reviews of screening for AF
   4. Interpreting single-lead ECGs for AF diagnosis

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Atrial Fibrillation

• 2020 ESC Guidelines: includes the ‘diagnostic criteria for atrial fibrillation’ in Section 3.2.
• 2021 NICE Guideline: includes the recommendation that ‘12?lead ECG should be used as the test to confirm atrial fibrillation, to prevent the use of less accurate ECG devices, such as mobile and lead?I ECG devices’.
• Responsible for a fivefold increase in stroke risk

Screening Studies

STROKESTOP Study

Websites:

• Registration

Study Design:

• Publication

Results:

• Screening (before follow-up)
• Follow-up outcomes, and accompanying Comment.
• Geographic and socio-demographic differences in uptake of screening
• Automated ECG analysis algorithm
• Cost-effectiveness

Follow-up study:

• Micro-AF as a risk factor for AF

STROKESTOP II Study

Websites:

• Registration

Study Design:

• Publication

Results:

• Screening (before follow-up)

SAFER Study

Websites:

• Study Website
• SAFER Feasibility Study registration
• SAFER Trial registration

Protocols:

• SAFER Trial Pilot
• SAFER Trial

Papers:

• Feasibility Study Results
• Embedding qualitative research in trials
• Why do people take part in atrial fibrillation screening?

Engineering Analyses:

• Algorithm tags and number of reviewers: initial results
• Prioritising ECGs for manual review
• Characterising RR-intervals

LOOP Study

Results:

• Follow-up outcomes, and accompanying Comment.

SCREEN-AF Study

Websites:

• Registration

Results:

• Screening

REHEARSE-AF Study

Results:

• Screening

PULsE-AI Trial

Results:

• Screening

AF Detection Studies

Apple Heart Study

• Study Design
• Results

FitBit Heart Study

• Results

Devices

Zenicor’s handheld ECG device

• Website, including Press images

AliveCor’s Kardia Mobile device

• Website

Withings wrist-watch devices

• Move-ECG
• ScanWatch

Cardiolund’s ECG Parser algorithm

• Website
• Initial Design
• Validation

Context

• Healthcare provider views on devices
• Systematic review and economic evaluation of lead-I ECG devices

Context

Single-time point screening

• Estimated stroke risk, yield, and number needed to screen for atrial fibrillation detected through single time screening

ECG-based AF screening

• Systematic review

Reviews of screening for AF

• Population-based screening for atrial fibrillation - see Table 4 for a list of ongoing studies.
• Screening for atrial fibrillation: A call for evidence
• Screening for atrial fibrillation

Interpreting single-lead ECGs for AF diagnosis

• Data from the VITAL-AF Trial