Mobile health technology applications on atrial fibrillation
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Abstract
Atrial fibrillation (AF) is the most common arrhythmia and affects over 5 million Americans today. Many AF related strokes occur without AF being diagnosed prior and often would be preventable with treatment such as anticoagulants. Since many cases of AF are paroxysmal in nature, they often go unseen during medical visits. However, with today’s advancing technology there are several mobile health (mhealth) devices that can be used in a home setting to screen or monitor a person’s heart rhythm. With so many different types of devices being put onto the market, it is important to measure their accuracy and feasibility to best understand the readings given by the devices. The following devices, Kardia Mobile by AliveCor, MyDiagnostick, Zio® Patch by iRhythm Technologies, Inc., and the Apple Watch, have been reviewed assessing their accuracy and, based on study availability, the overall patients’ experiences with the devices. The Kardia Mobile device had mixed results in accuracy, but favorable results when it came to participants’ experience when using the device. Its biggest drawback in ability to capture asymptomatic or paroxysmal AF, which is also applicable to the MyDiagnostick, is that it does not have constant monitoring. This may result in missing the aforementioned types of AF. The MyDiagnostick had consistently high specificity and sensitivity results and is very simple in design making it easy to use. The Zio® Patch did not have any studies comparing it directly to a gold standard 12-lead ECG, but was found by one study to be better at detecting AF compared to a 24-hour Holter monitor. It was also found to be user-friendly. The Apple Heart Study posed a good example of a very large enrollment reaching thousands and showed the algorithm to have a 0.84 positive predictive value, but did not provide any information on the algorithm’s sensitivity or specificity in detecting AF. Its biggest potential stems from the wide use of Apple products making it accessible as well as its constant background monitoring. Overall, all of the devices have promising features, and many have promising results, but should be further studied with emphasis on comparing the algorithms to 12-lead ECG standards and careful consideration of the study population demographics when interpreting results.
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Attribution 4.0 International