Tooley James E, Perez Marco Valentin
Cardiovascular Medicine, Stanford University, Stanford, California, USA.
Cardiovascular Medicine, Stanford University, Stanford, California, USA
Heart. 2022 May 12;108(11):834-839. doi: 10.1136/heartjnl-2020-318262.
Atrial fibrillation is a common arrhythmia associated with significant morbidity, mortality and decreased quality of life. Mobile health devices marketed directly to consumers capable of detecting atrial fibrillation through methods including photoplethysmography, single-lead ECG as well as contactless methods are becoming ubiquitous. Large-scale screening for atrial fibrillation is feasible and has been shown to detect more cases than usual care-however, controversy still exists surrounding screening even in older higher risk populations. Given widespread use of mobile health devices, consumer-driven screening is happening on a large scale in both low-risk and high-risk populations. Given that young people make up a large portion of early adopters of mobile health devices, there is the potential that many more patients with early onset atrial fibrillation will come to clinical attention requiring possible referral to genetic arrythmia clinic. Physicians need to be familiar with these technologies, and understand their risks, and limitations. In the current review, we discuss current mobile health devices used to detect atrial fibrillation, recent and upcoming trials using them for diagnosis of atrial fibrillation, practical recommendations for patients with atrial fibrillation diagnosed by a mobile health device and special consideration in young patients.
心房颤动是一种常见的心律失常,与显著的发病率、死亡率及生活质量下降相关。直接面向消费者销售的移动健康设备正变得无处不在,这些设备能够通过包括光电容积脉搏波描记法、单导联心电图以及非接触式方法在内的手段检测心房颤动。大规模筛查心房颤动是可行的,并且已证明其能比常规护理检测出更多病例——然而,即使在老年高危人群中,围绕筛查仍存在争议。鉴于移动健康设备的广泛使用,消费者驱动的筛查正在低风险和高风险人群中大规模进行。鉴于年轻人占移动健康设备早期采用者的很大一部分,有可能会有更多早发性心房颤动患者引起临床关注,需要转诊至遗传性心律失常诊所。医生需要熟悉这些技术,并了解其风险和局限性。在本综述中,我们讨论了目前用于检测心房颤动的移动健康设备、使用它们诊断心房颤动的近期及即将开展的试验、对通过移动健康设备诊断为心房颤动的患者的实用建议以及对年轻患者的特殊考虑。