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® 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® 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 CHAD₂DS₂- VASc 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.

Keywords: Atrial fibrillation; Early diagnosis; Interprofessional relations; Portable ECG; Portugal.