Catch-AF—Early Diagnosis of Symptomatic Arrythmias in the Waiting Period Prior to Seeing a Cardiologist in Victoria, British Columbia

Abstract Background Atrial fibrillation (AF) is the most common cardiac arrhythmia. Given its often-paroxysmal nature, screening at a single time point, using a 12-lead electrocardiogram (ECG) or a Holter monitor, has limited benefit. The AliveCor KardiaMobile device is a validated ECG recorder that can be used for patient-directed arrhythmia diagnosis and symptom–rhythm correlation. The aim of this study was to evaluate whether using the KardiaMobile device could reduce the time-to-diagnosis, for AF as well as other arrhythmias. We hypothesized that providing patients with a KardiaMobile device during their waiting period for specialist care could reduce the length of time that passes before ECG detection of arrhythmia. Methods Patients were randomized 1:1 to receive either standard monitoring (ECG and a Holter monitor) or enhanced monitoring (ECG, a Holter monitor, and a KardiaMobile device). Patients were instructed to upload ECG recordings if they had cardiac symptoms, so that symptom–rhythm correlation could be achieved. The primary outcome was the time-to-diagnosis for AF. The secondary endpoint was the time-to-diagnosis for any arrhythmias. Results From October 2018 to October 2022, a total of 69 patients were enrolled, and they were followed up to 12 months. Overall, 6 of the 7 patients diagnosed with AF were in the enhanced-monitoring group (P = 0.106). The time-to-diagnosis was not significantly different in the 2 groups (P = 0.053). Overall arrhythmias were diagnosed in 10 patients (29%) in the standard-monitoring arm, compared to 22 patients (63%) in the enhanced-monitoring arm (P = 0.008). The time-to-diagnosis was reduced in the enhanced-monitoring arm (P = 0.010). Conclusions The time-to-diagnosis of any arrhythmia was reduced significantly in patients randomized to receive KardiaMobile device monitoring. Providing patients with a KardiaMobile device may expedite the diagnosis of arrhythmias during the waiting period for specialist care. Clinical Trial Registration NCT04302311.