Keng Tat Koh1, Wan Chung Law2, Win Moe Zaw2, Diana Hui Ping Foo3, Chen Ting Tan1, Anderson Steven2, Desmond Samuel4, Tem Lom Fam4, Ching Hua Chai4, Zhai Sing Wong4, Sivaraj Xaviar1, Chandan Deepak Bhavnani5, Jason Seng Hong Tan5, Yen Yee Oon1, Asri Said1,6, Alan Yean Yip Fong1,3, Tiong Kiam Ong1. 1. Department of Cardiology, Sarawak Heart Centre, 3rd Roundabout, Samarahan Expressway, 94300 Kota Samarahan, Sarawak, Malaysia. 2. Department of Medicine, Neurology Unit, Sarawak General Hospital, Jalan Hospital, 93586 Kuching, Sarawak, Malaysia. 3. Clinical Research Centre, Institute for Clinical Research, Sarawak General Hospital, Jalan Hospital, 93586 Kuching, Sarawak, Malaysia. 4. Department of Medicine, Miri Hospital, Jalan Cahaya, 98000 Miri, Sarawak, Malaysia. 5. Department of Medicine, Bintulu Hospital, Jalan Bukit Nyabau, 97000 Bintulu, Sarawak, Malaysia. 6. Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300 Kota Samarahan, Sarawak, Malaysia.
Abstract
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-hHolter monitoring (control group, n = 98) vs. 30-day smartphoneECG 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. Published on behalf of the European Society of Cardiology. All rights reserved.
RCT Entities:
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. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Gregory Y H Lip; Deirdre A Lane; Radosław Lenarczyk; Giuseppe Boriani; Wolfram Doehner; Laura A Benjamin; Marc Fisher; Deborah Lowe; Ralph L Sacco; Renate Schnabel; Caroline Watkins; George Ntaios; Tatjana Potpara Journal: Eur Heart J Date: 2022-07-07 Impact factor: 35.855
Authors: Siti Nur Suhaidah Selamat; Rosalam Che Me; Husna Ahmad Ainuddin; Mazatulfazura S F Salim; Hafiz Rashidi Ramli; Muhammad Hibatullah Romli Journal: Front Public Health Date: 2022-02-07
Authors: Elaine Y Wan; Hamid Ghanbari; Nazem Akoum; Zachi Itzhak Attia; Samuel J Asirvatham; Eugene H Chung; Lilas Dagher; Sana M Al-Khatib; G Stuart Mendenhall; David D McManus; Rajeev K Pathak; Rod S Passman; Nicholas S Peters; David S Schwartzman; Emma Svennberg; Khaldoun G Tarakji; Mintu P Turakhia; Anthony Trela; Hirad Yarmohammadi; Nassir F Marrouche Journal: Cardiovasc Digit Health J Date: 2021-07-10
Authors: Marta Leńska-Mieciek; Aleksandra Kuls-Oszmaniec; Natalia Dociak; Marcin Kowalewski; Krzysztof Sarwiński; Andrzej Osiecki; Urszula Fiszer Journal: J Clin Med Date: 2022-01-27 Impact factor: 4.241
Authors: Saer Abu-Alrub; Marc Strik; F Daniel Ramirez; Nadir Moussaoui; Hugo Pierre Racine; Hugo Marchand; Samuel Buliard; Michel Haïssaguerre; Sylvain Ploux; Pierre Bordachar Journal: Front Cardiovasc Med Date: 2022-02-04