Beerten Simon Gabriël, Proesmans Tine, Vaes Bert
Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Qompium, Hasselt, Belgium.
JMIR Form Res. 2021 Apr 7;5(4):e24461. doi: 10.2196/24461.
Atrial 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.
We conducted a pilot study with the smartphone app FibriCheck to assess whether the introduction of such an app is feasible.
Four 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.
There 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.
FibriCheck 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.
ClinicalTrials.gov NCT03509493; https://clinicaltrials.gov/ct2/show/NCT03509493.
心房颤动（AF）是中风的主要危险因素。当前的机会性筛查程序包括脉搏触诊以及在发现心律不齐时进行心电图检查。可测量心律的智能手机应用程序可能有助于在初级保健环境中提高房颤的检测率。
我们使用智能手机应用程序FibriCheck进行了一项试点研究，以评估引入此类应用程序是否可行。
法兰德斯地区的四家普通诊所提供了研究的患者数据。参与者的纳入标准为年龄65岁及以上且CHARGE-AF评分至少为10%。我们排除了已知患有房颤或植入起搏器的患者。参与者被要求每天至少使用FibriCheck测量两次（至少14天）。在研究前后，他们都收到了36项简短健康调查（SF-36）问卷，以及关于他们用户体验和对技术总体看法的不同调查。
共有92名参与者（36名女性和56名男性）。研究人群在基线时的危险因素和药物使用方面相对同质。在研究期间，86名参与者中有5名（6%）被发现患有房颤（6名退出者）。平均研究期为23天，每天平均测量次数为2.1次。患者依从性各不相同，但较高。总体而言，生活质量没有明显变化。总体用户体验和满意度非常高。
FibriCheck是一款相对易于使用的智能手机应用程序，可辅助初级保健中的房颤筛查。在这种环境中实施它肯定是可行的，并且可以预期患者依从率很高。基于这些结果，一项计划中的整群随机试验将继续进行。
ClinicalTrials.gov NCT03509493；https://clinicaltrials.gov/ct2/show/NCT03509493
