A recent study published in Heart Rhythm shows that an app can identify atrial fibrillation (AF) with a high specificity and sensitivity.
A cohort of 76 adults with persistent AF were evaluated using the app before and after cardioversion.
The researchers took pulsatile time series recordings using the iPhone 4S camera.
An algorithm combined two statistical methods (root mean square of successive RR differences and Shannon entropy) to analyze the pulses in real time.
Results showed “excellent sensitivity (0.962), specificity (0.975), and accuracy (0.968) for beat-to-beat discrimination of an irregular pulse during AF from sinus rhythm” when compared to 12-lead EKG.
Surveys have shown that a growing percentage of patients trust self-tracking apps. Half of patients are willing to use apps that automatically communicate data to their physicians. This indicates that the app would be readily acceptable to a significant percentage of patients. Encouragement from the doctor, armed with peer-reviewed research, would only increase this trust.
This app would serve two populations: those that have been diagnosed with AF and those that are anxious about possibly having AF.
Those that diagnosed with AF are managed by cardiologists in one of two ways: rate control or rhythm control. Those that are rate controlled wouldn’t benefit from this app as this management method does not attempt to change the rhythm.
On the other hand, patients on antiarrhythmics (rhythm controlled) would have the greatest benefit. Patients would be able to regularly check if their treatment is working. If the app tells them that they have AF, they would know to call their cardiologist. During initial treatment, patients could provide data to their doctor showing how often they are entering AF as the antiarrhythmic drug concentration builds in their system.
Patients that are anxious about getting AF (often due to a family history) could use this app to check. If they are in AF, they can head over to the cardiologist. If not, they can be reassured of this fact.
As we know, in the age of modern technology, patients don’t always trust their physicians. For those that have been told that they do not have AF, this app could serve to reinforce the results received from their doctors. Of course, physicians should be aware of the risk for anxious patients to repeatedly check their rhythm. If it becomes a problem, then the anxiety itself should be addressed.