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NICE atrial fibrillation guideline snubs wearable technology: a missed opportunity?

NICE atrial fibrillation guideline snubs wearable technology: a missed opportunity?
NICE atrial fibrillation guideline snubs wearable technology: a missed opportunity?

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a growing public health epidemic. In the UK, over 1.3 million people have a diagnosis of AF and an estimated 400,000 remain undiagnosed. AF-related strokes account for a quarter of all strokes and, as AF episodes are often asymptomatic, are still often the first manifestation of AF. Early diagnosis and initiation of oral anticoagulation, where appropriate, may prevent some of these thromboembolic strokes. Public Health England is committed to decrease the incidence of AF-related strokes and has sponsored initiatives aimed at improving AF detection by promoting the uptake of wearable technologies. However, the National Institute for Health and Care Excellence (NICE) has not recommended wearable technology in their recent AF diagnosis and management guidelines (NG196). Diagnostic accuracy of single-lead electrocardiography (ECG) generated by the latest iteration of wearable devices is excellent and, in many cases, superior to general practitioner interpretation of the 12-lead ECG. High-quality ECG from wearable devices that unequivocally shows AF can expedite AF detection. Otherwise, there is a real risk of delaying AF diagnosis with the potential of devastating consequences for patients and their families.

Atrial fibrillation, Digital health technology, NICE, Stroke prevention, Wearables
1470-2118
77-82
Briosa e Gala, Andre
409c30a8-0696-4426-9f9b-2539af465dbd
Pope, Michael
4e7343b7-a8c4-4ce4-a813-ff0d894b0f92
Leo, Milena
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Lobban, Trudie
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Betts, Timothy R
a9d90073-a54a-478c-81f0-39ecc5234047
Briosa e Gala, Andre
409c30a8-0696-4426-9f9b-2539af465dbd
Pope, Michael
4e7343b7-a8c4-4ce4-a813-ff0d894b0f92
Leo, Milena
a9342a4e-2bd1-4c2a-bc1b-46a8ffa29842
Lobban, Trudie
f8d0c9fa-0303-4ba2-803b-42bd1b8dae21
Betts, Timothy R
a9d90073-a54a-478c-81f0-39ecc5234047

Briosa e Gala, Andre, Pope, Michael, Leo, Milena, Lobban, Trudie and Betts, Timothy R (2022) NICE atrial fibrillation guideline snubs wearable technology: a missed opportunity? Clinical medicine (London, England), 22 (1), 77-82. (doi:10.7861/clinmed.2021-0436).

Record type: Article

Abstract

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a growing public health epidemic. In the UK, over 1.3 million people have a diagnosis of AF and an estimated 400,000 remain undiagnosed. AF-related strokes account for a quarter of all strokes and, as AF episodes are often asymptomatic, are still often the first manifestation of AF. Early diagnosis and initiation of oral anticoagulation, where appropriate, may prevent some of these thromboembolic strokes. Public Health England is committed to decrease the incidence of AF-related strokes and has sponsored initiatives aimed at improving AF detection by promoting the uptake of wearable technologies. However, the National Institute for Health and Care Excellence (NICE) has not recommended wearable technology in their recent AF diagnosis and management guidelines (NG196). Diagnostic accuracy of single-lead electrocardiography (ECG) generated by the latest iteration of wearable devices is excellent and, in many cases, superior to general practitioner interpretation of the 12-lead ECG. High-quality ECG from wearable devices that unequivocally shows AF can expedite AF detection. Otherwise, there is a real risk of delaying AF diagnosis with the potential of devastating consequences for patients and their families.

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clinmed-22-1-77 - Version of Record
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e-pub ahead of print date: 25 January 2022
Additional Information: Funding Timothy R Betts and Andre Briosa e Gala received a Heart Research UK novel and emerging technologies grant to investigate the role of wearable devices in AF management (RG2689/20/22). Affils: T Betts, John Radcliffe Hospital, Oxford, UK, University of Oxford, Oxford, UK and NIHR Oxford Biomedical Research Centre, Oxford, UK
Keywords: Atrial fibrillation, Digital health technology, NICE, Stroke prevention, Wearables

Identifiers

Local EPrints ID: 456352
URI: http://eprints.soton.ac.uk/id/eprint/456352
ISSN: 1470-2118
PURE UUID: 15dd99a7-c2fb-4d8d-b548-61aa57d97ad3

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Date deposited: 27 Apr 2022 02:28
Last modified: 23 Jul 2022 01:59

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Contributors

Author: Andre Briosa e Gala
Author: Michael Pope
Author: Milena Leo
Author: Trudie Lobban
Author: Timothy R Betts

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