OasisLMS

Join host Melissa Middeldorp and her guests Marco Perez and Kristie Coleman for this installment of The Lead!

This multicenter randomized controlled trial evaluated whether smartwatch-based rhythm monitoring improves detection of previously undiagnosed atrial fibrillation (AF) in cardiology outpatients aged ≥65 years with elevated stroke risk. A total of 437 participants were randomized to either 6-month monitoring with an Apple Watch integrating photoplethysmography-based irregular rhythm detection and single-lead ECG confirmation, supported by a telemonitoring adjudication pathway, or to standard care. The primary endpoint of new AF occurred significantly more often in the intervention group than in controls (9.6% vs 2.3%; HR 4.40), with many cases asymptomatic and detected earlier through wearable monitoring. All diagnosed patients were initiated on anticoagulation, and major adverse cardiovascular events were similar between groups. Overall, the study demonstrates that prolonged smartwatch-based screening embedded within a clinical workflow substantially increases AF detection in a high-risk population, highlighting the feasibility of wearable-enabled case finding while underscoring ongoing questions regarding clinical outcomes and optimal implementation

Describe the design and key findings of a randomized trial evaluating smartwatch-based screening for atrial fibrillation in older patients at elevated stroke risk.

Discuss the clinical implications, limitations, and broader evidence context of wearable-enabled atrial fibrillation detection within contemporary screening strategies.  

Article Authors

Nicole J. van Steijn, Isabel S. Blommestijn, Sebastiaan Blok, Shari Pepplinkhuizen, Aernout Somsen, Reinoud E. Knops, Laura Breukel, Jan G.P. Tijssen, Igor I. Tulevski, Philip M. Croon, Michiel M. Winter

Podcast Contributors

Melissa E. Middeldorp, MPH, PhD
Kristie Coleman, MPH, RN
Marco Perez, MD

All relevant financial relationships have been mitigated.

Host and Contributor Disclosure(s):

M. Middeldorp

M. Perez

Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner):

S. Sailor: No relevant financial relationships with ineligible companies to disclose.