A Heart Rate Monitoring App (FibriCheck) for Atrial Fibrillation in General Practice: Pilot Usability Study.

Simon Gabriël Beerten,Bert Vaes,Tine Proesmans

doi:10.2196/24461

Abstract

BackgroundAtrial 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 apps that measure heart rhythm could be useful in increasing the detection of AF in a primary care setting.ObjectiveWe conducted a pilot study with the smartphone app FibriCheck to assess whether the introduction of such an app is feasible.MethodsFour general practices across Flanders provided patient data for the study. Inclusion criteria for participants were aged 65 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 (for at least 14 days). They were provided the 36-Item Short Form Survey (SF-36) questionnaire both before and after the study, as well as different surveys concerning their user experience and general perception of technology.ResultsThere were 92 participants (36 women and 56 men). The study population was relatively homogenous concerning risk factors and medication use at baseline. During the study period, 5/86 (6%) participants were found to have AF (6 dropouts). The average study period was 23 days and the average number of measurements per day was 2.1. Patient compliance was variable, but high. On the whole, there were no appreciable changes in quality of life. The overall user experience and satisfaction were very high.ConclusionsFibriCheck is a relatively easy-to-use smartphone app 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.Trial RegistrationClinicalTrials.gov NCT03509493; https://clinicaltrials.gov/ct2/show/NCT03509493

Highlights

Atrial fibrillation (AF) has long been known as an independent risk factor for stroke [1]
FibriCheck is a relatively easy-to-use smartphone app to complement AF screening in primary care
Participants were most satisfied with the following aspects of the app: simplicity (52/71, 73%), on-the-go heart rhythm analysis (52/71, 73%), and the possibility to be followed remotely (48/71, 68%). This pilot study concerned the ease of use and implementation of the AF case-finding app FibriCheck in primary care

Summary

Introduction

Atrial fibrillation (AF) has long been known as an independent risk factor for stroke [1]. It is highly prevalent among older patients in primary care, and the incidence is seemingly on the rise [2,3]. Hospitalizations for stroke are an important financial burden to the society, so a strategy for early and cost-effective screening interventions seems useful [4]. Current best clinical practice points to an opportunistic screening approach to detect AF, in which at-risk patients undergo routine pulse palpations and electrocardiograms (ECGs) when an irregular rhythm has been found [5,6]. The current opportunistic screening procedure consists of pulse palpation and an electrocardiogram when an irregular rhythm is found. Smartphone apps that measure heart rhythm could be useful in increasing the detection of AF in a primary care setting

Methods

Results

Discussion

Conclusion