Identification of Atrial Fibrillation in Secondary Care Diabetes and Vascular Clinics: A Pilot Study

Abstract

Aim: To determine the feasibility and utility of the AliveCor^® handheld ECG device in screening for asymptomatic atrial fibrillation in high-risk patients attending secondary care clinics. Materials & methods: Patients were recruited from diabetes and vascular outpatient clinics, and the AliveCor device used to store a 30-second ECG recording. Clinical risk stratification systems (CHAD₂S₂-VAS_c and HAS-BLED) assessed individual suitability for oral anticoagulation. Results: Atrial fibrillation was detected in 2 of 149 patients (1.3%), with CHA₂DS₂-VAS_c-derived annual stroke risk of 4%. Given low bleeding susceptibility (HAS-BLED), oral anticoagulation was strongly indicated. Conclusion: AliveCor technology offers a simple approach to retrieve large volumes of ECG data. A follow-up study with a larger cohort would reinforce the clinical utility of screening this high-risk population.

Keywords:

• AliveCor
• anticoagulation
• atrial fibrillation
• CHAD₂S₂-VAS_c
• ECG
• HAS-BLED
• screening
• stroke

Author contributions

K Kalia and N Grubb designed the project, K Kalia performed the analysis and K Kalia, RM Tulloh and N Grubb were involved in data interpretation and writing and approving the final draft.

Acknowledgments

Many thanks to T Harper, lead research nurse at the Edinburgh Clinical Trials Unit, for providing the AliveCor^® ECG recording device.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that the study protocol was approved by the institution’s ethical committee on human research. Formal approval was waived subject to the non-invasive and anonymized nature of the study. Informed consent was obtained from all participants prior to recruitment and access to confidential clinical notes.

Data sharing statement

This manuscript reports original results. Individual participant data will not be made available at a later date.