Raising awareness and early detection of atrial fibrillation, an experience resorting to mobile technology centred on informed individuals

Abstract

Background: Atrial fibrillation (AF) is a cardiac arrhythmia responsible for one third of ischemic strokes. Early detection of AF plays an important role in preventing embolic stroke. Objectives: This study aimed to test the feasibility of an awareness event including opportunistic screening for atrial fibrillation; and to test the reliability of the innovative portable electrocardiogram (ECG) device used. Methods: An awareness campaign was held during two weeks, where individuals consenting to participate in a pharmacist-led detection event, received a manual pulse check, were clinically evaluated and subject to a single lead electrocardiogram using AliveCor Kardia (R) mobile. ECGs highlighted as possible AF were confirmed by the cardiologist and those signalled with abnormalities in cardiac rhythm were referred to their physician. Data were collected in a password protected application and analyzed using SPSS, v.24. The Kardia (R) mobile's sensitivity and specificity was tested against the standard 12-lead ECG. Results: The awareness event involved 223 individuals, among which 205 were screened. Mean age was 66 years (SD = 15) and hypertension was the most frequently reported (n = 107; 52.2%). Mean CHAD2DS2VASc score was 3 (SD = 1.8). Cardiac irregularities were identified in 45 individuals, 14 confirmed to be new cases of AF (6.8%) by the cardiologist. The sensitivity and specificity were 90.9% and 97.4%. Conclusion: Data suggests this device to be potentially useful for opportunistic early detection of AF, provided interprofessional collaboration is guaranteed so that suspect cases are adequately managed and in a timely way. Fourteen new cases of AF were identified in the population studied, suggesting the pharmacist working in a multiprofessional context, may have had an important role in preventing potential ischemic-related strokes with this initiative. All healthcare professionals involved in the patient pathway should play a more active role in contributing to better health outcomes, particularly within primary care.