Detection of Asymptomatic Atrial Fibrillation in persons of 65 year of age or older

Rationale:

Atrial fibrillation (AF) is the most common cardiac arrhythmia. Although the condition itself is not life-threatening, the complications result in increased morbidity and mortality. AF is often asymptomatic and a considerable number of people suffering from AF are not aware of their condition. Unfortunately, a cerebral infarction is often the first clinical manifestation. The idea to screen persons opportunistically for Asymptomatic Atrial Fibrillation (AAF) was infeasible until recently. However, with a recently-developed smartphone connected Mobile ECG Device (MED), this seems to be feasible after all.



Study design:

A non WMO obligation, prospective study to examine the feasibility of screening persons of ≥ 65 year old for AAF.



Study population:

The study population will consist of a large group of people with not known AF until the screening.



Main study parameters/endpoints:

• To examine the feasibility of screening persons ≥65 years old for AAF

• To validate the smartphone connected MED as AAF screening instrument for application in transmural care in the Netherlands.

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Data collection:

The following data will be collected: age, gender, screening location, reason for screening, CHA2DS2-VASc score, sECG, sECG algorithm outcome, expert team sECG rhythm assessment , “sECG algorithm outcome vs observer assessment outcome” variability and “sECG inter- observer assessment” variability.



Nature and extent of the burden and risks due to participation:

The screening for this study will be combined with to determined visit of candidates to their family doctor or another event. The candidates have to give digital informed consent and will be asked to answer a minimum of questions (age, gender, screeninglocation, reason for screening, CHA2DS2-VASc score). Than an ECG will be made with the MED by holding a little stick with both hands.

If the automated MED automated AF algorithm gives “normal ECG” as result the study will end for the candidate.

If the MED gives “abnormal ECG” as result patient will be referred to medical healthcare for AF for further investigation and probable AF treatment.

For the study there will be no further investigation or follow-up.

All sECGs will be analysed by the sECG-expert team, if abnormalities are observed by this team the family doctor will be informed. The family doctor has the connection between the sECG code and the patient details and will contact the patient.

The smartphone connected MED as AAF is a valid screening instrument for application in transmural care in the Netherlands.

screening for AAF with mobile ECG device at T=0. After screening for AAF the study is ended for the patient

screening persons ≥65 years old for AAF (Asymptomatic Atrial Fibrillation)