Blood thinners reduce the risk of stroke in atrial fibrillation
Atrial fibrillation, the most common cardiac arrhythmia, is associated with an increased risk of stroke. Researchers are now reporting that this arrhythmia can be detected with the help of smartphones. The targeted use of blood thinners can reduce the risk of stroke for those affected.
A study of smartphone-based screening for atrial fibrillation found that this digital technology offers significant advantages in detecting this cardiac arrhythmia and has the potential for widespread applicability due to the wide availability of smartphones. The study results were published in the journal “Nature Medicine”.
Atrial fibrillation is often not recognized in time
As stated in a current communication from the LMU Klinikum (University of Munich Hospital), atrial fibrillation is the most common arrhythmia in the Western world and is responsible for around 25 percent of all ischemic strokes.
Prophylactic therapy with anticoagulants (colloquially: blood thinners) can drastically reduce the risk of strokes in cases of atrial fibrillation. A big problem, however, is that in many patients atrial fibrillation is not recognized in a timely manner.
Due to continuous technical progress, innovative strategies, especially in telemedical monitoring, are increasingly finding their way into the medical field.
Numerous studies have demonstrated increased detection of previously unknown atrial fibrillation through opportunistic screening using photoplethysmographic pulse wave analysis (PPG). This analysis can be carried out very easily through the cameras of smartphones or smartwatches.
However, the effectiveness of this digital screening strategy in direct comparison to conventional screening for atrial fibrillation has not yet been sufficiently researched.
Digital strategy compared with conventional screening
The now published “eHealth-based Bavarian alternative detection of Atrial Fibrillation (eBRAVE-AF)” study was carried out by the Medical Clinic I of the LMU Klinikum in collaboration with the Medical University of Innsbruck under the direction of Prof. Dr. Axel Bauer and PD Dr. Konstantinos Rizas from the Medical Clinic and Polyclinic I at the LMU Clinic in Munich.
67,488 policyholders from the Bavarian Insurance Chamber, selected based on age (50 years and older) and other risk factors, were informed about the study by post and invited to take part in the study.
A digital strategy for atrial fibrillation screening was compared with conventional screening for atrial fibrillation in 5,551 participants.
The digital screening consisted of repeated one-minute pulse wave measurements using a certified smartphone app (Preventicus Heartbeats) and, in the event of an abnormal measurement, the findings were then confirmed by a long-term ECG.
Early detection of cardiac arrhythmia
“We conducted the study purely digitally without physical contact with the study participants. That was a big challenge. Our most important tool for communication and coordination was a specially developed study app on the participants’ smartphones,” explains Bauer.
A total of 125 participants were newly diagnosed with atrial fibrillation during the course of the study. In 100 of these people, this diagnosis led to the initiation of treatment with anticoagulants to prevent stroke.
In addition, digital smartphone screening has led to a doubling of the sensitivity for detecting atrial fibrillation.
“The results of this study are of great importance for the early detection of atrial fibrillation, a cardiac arrhythmia that is associated with an increased risk of stroke without treatment,” says private lecturer Dr. Rizas.
“The technology can be easily used in all smartphones with iOS or Android operating systems and could lead to the establishment of population-wide early detection programs for the diagnosis of atrial fibrillation and the prevention of strokes.”
According to the expert, future studies must now clarify to what extent this digital screening strategy can improve the prognosis of patients in the long term. (ad)