Screening for atrial fibrillation using economical and accurate technology (From the SAFETY study)

Abstract

The prevalence of Atrial Fibrillation (AF) is estimated at more than 3% in the adult population and there has been increased interest in screening for AF. In the SAFETY trial we chose to evaluate if inexpensive, wearable, consumer ECG sensing devices (Polar-H7 (PH7) and Firstbeat Bodyguard 2 (BG2)), could be used to detect AF accurately. We undertook a case-control study of 413 participants aged > 65 (79 with AF/Flutter at the study visit and 336 without) attending 3 general practice surgeries in Hampshire, UK for a single screening visit. The PH7 and BG2 devices were tested alongside 2 established AF detection devices (AliveCor and WatchBP) in random order and the diagnosis of AF was confirmed by 12-Lead ECG interpreted by a panel of cardiologists. The sensitivity (95% CI range), specificity (95% CI range) and overall accuracy (95% CI range) of the 4 devices were: AliveCor: 87.8% (78.7-94.0%), 98.8% (97.0–99.7%), 96.7% (94.4-98.2%); WatchBP: 96.3% (89.7-99.2%), 93.5% (90.3-95.9%), 94.0% (91.3-96.1%): PH7: 96.3% (89.7-99.2%), 98.2% (96.2-99.3%), 97.9% (96.0-99.0%). BG2: 96.3% (89.7 – 99.2%), 98.5% (96.6-99.5%), 98.1% (96.3-99.2%). The PH7 & BG2 devices were highly reliable (the devices acquired sufficient data and obtained a diagnostic result in all but 1 participant on the first attempt.) In conclusion, Inexpensive, consumer heart rate monitoring devices (PH7 and BG2) can be used to detect AF accurately with sensitivity and specificity > 95%. The consumer devices performed as well or better than WatchBP and AliveCor and have the capability to store or transmit ECG data which could be used to confirm AF.

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Identifiers

ORCID for Mark Lown: orcid.org/0000-0001-8309-568X

ORCID for Beth Stuart: orcid.org/0000-0001-5432-7437

ORCID for Paul Little: orcid.org/0000-0003-3664-1873

ORCID for Michael Moore: orcid.org/0000-0002-5127-4509

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