Wearable, long-term continuous heart monitors have been found to identify 52% more cases of atrial fibrillation compared to usual care, according to a study led by the Duke Clinical Research Institute. This discovery, reported at the European Society of Cardiology meeting, did not, however, result in a reduction in hospitalizations due to stroke. The study was unable to definitively establish whether atrial fibrillation screening actually lowers stroke rates due to the early halt of the study caused by the COVID-19 pandemic. Lead author Renato Lopes emphasized the importance of diagnosing atrial fibrillation, as it can increase the risk of ischemic stroke.
The study included approximately 12,000 patients in the U.S. who were at least 70 years old with no history of atrial fibrillation. Half of the patients were randomly assigned to receive a long-term continuous monitoring device for 14 days, while the other half received usual care. Over a median follow-up period of 15 months, a 52% increase in the number of atrial fibrillation cases diagnosed was observed among those wearing the monitoring device. There was no notable increase in rates of hospitalization for bleeding, and there was no significant reduction in the rate of hospitalizations for all strokes compared to usual care.
The study was originally intended to enroll 52,000 patients to determine if screening reduces the number of strokes. A larger study population is necessary as strokes occur in only a subset of patients with atrial fibrillation. Despite the inconclusive results, the study provided valuable insights that could inform future studies. The virtual format of enrolling and screening patients online with self-applied patch devices in their homes could be replicated in future research endeavors.
In addition to Lopes, the study included authors such as Steven J. Atlas, Alan S. Go, Steven A. Lubitz, and David D. McManus. The study received funding support from the Bristol-Myers Squibb/Pfizer Alliance. Further research is needed to definitively establish the impact of atrial fibrillation screening on stroke rates and to determine if early identification and treatment of atrial fibrillation can lower the risk of stroke. The use of wearable, long-term continuous heart monitors shows promise in detecting atrial fibrillation that may have otherwise gone undiagnosed, potentially improving patient outcomes in the future.
