Key result
Pharmacy-based smartphone ECG/PPG screening detects new AF in ~7% of adults, prompting rapid anticoagulation.
Why the study?
Many AF cases are paroxysmal or asymptomatic and remain undetected until stroke, while smartphone PPG and single-lead ECG in community pharmacies offer an accessible screening modality.
Does smartphone-based atrial fibrillation screening using PPG and single-lead ECG effectively detect atrial fibrillation and lead to anticoagulation initiation in adults aged 55 years and older in community pharmacies?
Cross-Sectional (n=425)
Yes
Does smartphone-based atrial fibrillation screening using PPG and single-lead ECG effectively detect atrial fibrillation and lead to anticoagulation initiation in adults aged 55 years and older in community pharmacies?
Smartphone-based AF screening in community pharmacies is a high-yield, accurate strategy that effectively leads to appropriate anticoagulation initiation in older adults.
Supports feasibility of pharmacy-based smartphone AF screening with high anticoagulation uptake; hypothesis-generating pending randomized outcome trials.
Many cases of atrial fibrillation (AF) are paroxysmal or asymptomatic and remain undetected until a thromboembolic stroke. Smartphone-based detection through photoplethysmography (PPG) and single-lead ECG offers a low-cost screening modality, and community pharmacies provide an accessible setting with high routine footfall. We screened 425 adults aged 55 years and older across sixteen urban and semi-urban community pharmacies over a six-month period. AF was newly detected in 31 individuals (7.3%), with detection rates rising from 0.8% in those under 55 to 12.4% in those aged 75 and over. The single-lead ECG device achieved an area under the ROC curve of 0.94 against cardiologist 12-lead ECG, while smartphone PPG achieved 0.89. Of newly detected AF cases, 29 (93.5%) had a CHA₂DS₂-VASc score of 2 or higher and met criteria for oral anticoagulation; 24 (77.4%) initiated anticoagulation within 30 days of screening. The yield, accuracy, and downstream anticoagulation uptake support pharmacy-based smartphone AF screening as a scalable strategy for early detection in older adults.
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Singh et al. (2026) conducted a cross-sectional in Atrial Fibrillation (n=425). Smartphone-based AF screening (PPG and single-lead ECG) vs. Cardiologist 12-lead ECG was evaluated on Newly detected atrial fibrillation. Pharmacy-based smartphone screening using single-lead ECG and PPG detected new atrial fibrillation in 7.3% of adults, with 77.4% of eligible patients initiating anticoagulation within 30 days.
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