Key result
Single-lead mobile ECG screening feasibly detects AFib in high-risk clinics, requiring ~3.5 minutes per patient.
Why the study?
Single-lead mobile ECGs may enable rapid, noninvasive screening for AFib in outpatient settings, but feasibility, accuracy, and cost-effectiveness in high-risk populations require demonstration.
Does routine single-lead mobile ECG screening improve detection of subclinical atrial fibrillation in high-risk outpatient populations without disrupting clinic flow?
Observational (n=2,339)
Yes
Does routine single-lead mobile ECG screening improve detection of subclinical atrial fibrillation in high-risk outpatient populations without disrupting clinic flow?
Routine screening for atrial fibrillation using a 30-second smartphone-based ECG in high-risk outpatient clinics is feasible, rapid, and well-accepted by medical staff.
May enable AF screening in high-risk clinics; hypothesis-generating, requires RCTs to confirm detection benefits.
BACKGROUND Single-lead, smartphone-based mobile electrocardiograms (ECGs) have the potential to provide a noninvasive, rapid, and cost-effective means of screening for atrial fibrillation (AFib) in outpatient settings. AFib has been associated with various comorbid diseases that prompt further investigation and screening methodologies for at-risk populations. A simple 30-second sinus rhythm strip from the KardiaMobile ECG (AliveCor) can provide an effective screen for cardiac rhythm abnormalities. OBJECTIVE The aim of this study is to demonstrate the feasibility of performing Kardia-enabled ECG recordings routinely in outpatient settings in high-risk populations and its potential use in uncovering previous undiagnosed cases of AFib. Specific aim 1 is to determine the feasibility and accuracy of performing routine cardiac rhythm sampling in patients deemed at high risk for AFib. Specific aim 2 is to determine whether routine rhythm sampling in outpatient clinics with high-risk patients can be used cost-effectively in an outpatient clinic without increasing the time it takes for the patient to be seen by a physician. METHODS Participants were recruited across 6 clinic sites across the University of Florida Health Network: University of Florida Health Nephrology, Sleep Center, Ophthalmology, Urology, Neurology, and Pre-Surgical. Participants, aged 18-99 years, who agreed to partake in the study were given a consent form and completed a questionnaire regarding their past medical history and risk factors for cardiovascular disease. Single-lead, 30-second ECGs were taken by the KardiaMobile ECG device. If patients are found to have newly diagnosed AFib, the attending physician is notified, and a 12-lead ECG or standard ECG equivalent will be ordered. RESULTS As of March 1, 2024, a total of 2339 participants have been enrolled. Of the data collected thus far, the KardiaMobile rhythm strip reported 381 abnormal readings, which are pending analysis from a cardiologist. A total of 78 readings were labeled as possible AFib, 159 readings were labeled unclassified, and 49 were unreadable. Of note, the average age of participants was 61 (SD 10.25) years, and the average self-reported weight was 194 (SD 14.26) pounds. Additionally, 1572 (67.25%) participants report not regularly seeing a cardiologist. Regarding feasibility, the average length of enrolling a patient into the study was 3:30 (SD 0.5) minutes after informed consent was completed, and medical staff across clinic sites (n=25) reported 9 of 10 level of satisfaction with the impact of the screening on clinic flow. CONCLUSIONS Preliminary data show promise regarding the feasibility of using KardiaMobile ECGs for the screening of AFib and prevention of cardiological disease in vulnerable outpatient populations. The use of a single-lead mobile ECG strip can serve as a low-cost, effective AFib screen for implementation across free clinics attempting to provide increased health care accessibility. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/52647
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Mittal et al. (2023) conducted an observational in Atrial fibrillation (n=2,339). KardiaMobile ECG was evaluated on Feasibility and accuracy of routine cardiac rhythm sampling. Single-lead mobile ECG screening in high-risk outpatient clinics was feasible, taking an average of 3.5 minutes per patient, and identified 78 possible cases of AFib among 2339 patients.
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