Key result
Digital 7-day patch ECG screening detects new AF in ~2% of at-risk older adults.
Why the study?
Conventional screening modalities for AF are constrained by considerable resource and logistical demands, prompting evaluation of a fully digital nationwide recruitment and patch-based ECG screening strategy.
Does a fully digital patch-based electrocardiogram screening strategy over seven days identify previously undiagnosed atrial fibrillation and lead to anticoagulation initiation compared to usual care in individuals aged ≥65 years with stroke risk factors?
RCT (n=50,549)
1:1
No
Does a fully digital patch-based electrocardiogram screening strategy over seven days identify previously undiagnosed atrial fibrillation and lead to anticoagulation initiation compared to usual care in individuals aged ≥65 years with stroke risk factors?
A nationwide, fully digital, site-less 7-day patch ECG screening strategy in at-risk older adults effectively identified previously undiagnosed atrial fibrillation in 1.9% of screened individuals, with 95.8% subsequently initiating anticoagulation therapy.
Supports digital patch-based AF screening in older adults at risk; extends RCT evidence on detection rates and anticoagulation uptake.
Background Conventional screening modalities for atrial fibrillation (AF) are often constrained by considerable resource and logistical demands. The randomised controlled Norwegian AF Self-Screening trial (NORSCREEN) adopts a fully digital approach to participant recruitment and trial implementation. Purpose To evaluate the effectiveness of a fully digital recruitment and screening strategy in nationwide AF screening, determine the prevalence of screen-detected AF, and assess adherence to therapeutic recommendations for anticoagulation therapy. Methods Individuals aged ≥65 years with at least one additional risk factor for stroke were digitally recruited from the general Norwegian population and randomized 1:1 to screening or usual care. Exclusion criteria were prior AF, current anticoagulation therapy, implantable cardiac electronic devices, or lack of smartphone access. Participants allocated to screening received a patch-based electrocardiogram sensor by mail for site-less continuous monitoring over seven days. Individuals with screen-detected AF were advised to contact their general practitioner to initiate guideline-directed therapy. Results A total of 551,555 residents were digitally invited. Of these, 139,596 (25.3%) completed the digital eligibility assessment, 74,956 (53.7%) were eligible, and 50,549 (67.4%) consented to participate (Figure 1). The median age was 75 years [IQR: 69-78], 23,445 (46.4%) were female, and the mean CHA2DS2-VA risk score was 2.6 ±0.9. In the screening group, 19,723 (78.1%) completed the study procedures. Previously undiagnosed AF was identified in 382 (1.9%) screened participants (Figure 2). The proportion of participants with screen-detected AF increased with age and was significantly higher in men than in women (2.6% vs 1.2%, p≤0.001). 95.8% of the participants with screen-detected AF reported initiating anticoagulation therapy. Conclusions The NORSCREEN trial demonstrates that fully digital, large-scale, site-less AF screening is feasible and effective in an at-risk population, identifying previously undiagnosed AF in 1.9% of screened individuals and showing high adherence to anticoagulation therapy recommendations.Figure 1Figure 2
No takes yet. Share an insight, caveat, or question.
Boskovic et al. (2026) conducted an RCT in Atrial fibrillation (n=50,549). Patch-based ECG sensor continuous monitoring vs. Usual care was evaluated on Prevalence of screen-detected atrial fibrillation. Fully digital 7-day patch-based ECG screening identified previously undiagnosed AF in 1.9% of screened at-risk older adults, with 95.8% initiating anticoagulation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: