Wearable heart monitors that provide long-term continuous tracking have been found to detect 52% more cases of atrial fibrillation compared to standard care. However, this increase in detection did not translate into a decrease in hospitalizations caused by strokes, as revealed by a recent study.
Wearable heart monitors that continuously track heart activity over a long term identified 52% more cases of atrial fibrillation compared to conventional methods, but this did not result in fewer hospitalizations from strokes, according to a study conducted by the Duke Clinical Research Institute.
The results, presented on September 1 at the European Society of Cardiology conference and published in the Journal of the American College of Cardiology, provide unclear indications regarding whether screening for atrial fibrillation effectively reduces stroke occurrences. The COVID pandemic caused an early halt in the study before it could fully enroll participants, preventing it from gathering enough data to draw solid conclusions regarding stroke rates.
“Atrial fibrillation often goes undiagnosed and can heighten the risk of ischemic stroke, which can primarily be reversed with oral anticoagulation,” stated the lead author Renato Lopes, M.D., Ph.D., a medical professor and member of the Duke Clinical Research Institute.
“What we still need is clear evidence that systematically diagnosing atrial fibrillation through screening can lead to treatment with oral anticoagulants, and subsequently, reduce stroke risk,” Lopes added.
The study included around 12,000 U.S. patients aged 70 and older, all with no prior diagnosis of atrial fibrillation. About half of them were randomly selected to use a long-term monitoring device for 14 days, while the other half received standard care.
After a median follow-up of 15 months, the study showed a 52% rise in diagnosed cases of atrial fibrillation among those using the monitoring device compared to those who received standard care. There was no rise in hospitalization rates for bleeding, and the rate of hospitalization for strokes showed no significant decline compared to the standard care group.
The original goal for the study was to enroll 52,000 participants, which would have provided the statistical power to determine whether screening leads to fewer strokes. A large sample size is essential because strokes only occur in a portion of patients with atrial fibrillation.
“Although the results are inconclusive, we have learned valuable lessons that could shape future research,” Lopes remarked. He noted that the study’s design allowed for online enrollment and screening in a virtual format, utilizing self-applied patch devices at home with remote support, which could be replicated in future studies.
Other authors of the study include Steven J. Atlas, Alan S. Go, Steven A. Lubitz, David D. McManus, Rowena J. Dolor, Ranee Chatterjee, Michael B. Rothberg, David R. Rushlow, Lori A. Crosson, Ronald S. Aronson, Michael Patlakh, Dianne Gallup, Donna J. Mills, Emily C. O’Brien, and Daniel E. Singer.
The study received funding from the Bristol-Myers Squibb/Pfizer Alliance.
