Screening for Atrial Fibrillation using Economical and Accurate TechnologY (SAFETY) – a pilot study

Atrial Fibrillation (AF) is a type of irregular heart rhythm that can lead to the formation of blood clots in the heart. These clots can dislodge causing a stroke.  About 5% of people between 65 and 74 will have AF which is often intermittent and symptomless.  We can only diagnose this type of AF by monitoring the heart rhythm with Electrocardiograms (ECGs) over 24 to 48 hours. Drugs that thin the blood (anti-coagulants) are effective in reducing this cause of stroke by approximately 60%. With effective AF screening, it is estimated that about 12% of all strokes in the UK could be prevented but at the moment there is no UK screening programme.

Several relatively low cost proprietary devices with good accuracy now exist which can be used to detect AF including WatchBP and AliveCor. These measure the electrical heart trace or pulse over short time periods (less than a few minutes). They can also be used in GP surgeries to screen for AF. Other devices such as heart rate monitors and activity trackers are also widely available, can measure heart or pulse rate for prolonged periods, and may have potential as screening tools for AF. We are currently unsure of their accuracy. A bespoke smartphone application (App) has been developed by ML, using a heart rate monitor, and tested using a benchmark ECG database with excellent initial results.

We wish to investigate the overall accuracy of WatchBP, AliveCor and the new App as simple cheap approaches for screening people in the community to see if they have AF. We also aim to evaluate the user experience in terms of comfort, ease of use and suitability for prolonged monitoring with a view to detecting AF and intermittent AF in the community.

Amount awarded: £54,621