JMIR Publications

ABSTRACT

Background:

Atrial fibrillation (AF) is a major risk factor for stroke. The current opportunistic screening procedure consists of pulse palpation and an electrocardiogram when an irregular rhythm is found. Smartphone applications that measure heart rhythm could be useful in increasing detection of AF in a primary care setting. We conducted a pilot study with the smartphone application FibriCheck® to assess whether the introduction of such an application is feasible.

Objective:

To assess the implementation of the FibriCheck® app in a primary care setting.

Methods:

Four general practices across Flanders provided patient data for the study. Inclusion criteria for participants were: 65 years or older and a CHARGE-AF score of at least 10%. We excluded patients with known AF or a pacemaker. Participants were asked to measure at least twice a day with FibriCheck®, during at least 14 days. They were provided the SF36 questionnaire both before and after the study, as well as different surveys concerning their user experience and general perception of technology.

Results:

There were 92 participants, of which 36 women and 56 men. The study population was relatively homogenous concerning risk factors and medication use at baseline. During the study period, 5.8% of the participants were found to have AF. The average study period was 23 days and the average number of measurements per day was 2.1. Patient compliance was variable, but high. There was no significant change in quality of life after the study. The overall user experience and satisfaction was very high.

Conclusions:

FibriCheck® is a relatively easy-to-use application to complement AF screening in primary care. Its implementation in this setting is certainly achievable, and one can expect high rates of patient compliance. Based on these results, a planned cluster randomized trial will be going ahead. Clinical Trial: Retrospectively registered on April 26, 2018 at clinicaltrials.gov with ID number NCT03509493.