Remote Screening for Atrial Fibrillation by a Federal Cardiac Monitoring System in Primary Care Patients in Russia: Results from the Prospective Interventional Multicenter FECAS-AFS Study
Daria Gognieva,
Nelly Vishnyakova,
Yulia Mitina,
Petr Chomakhidze,
Dinara Mesitskaya,
Natalia Kuznetsova,
Mohamed Khiari,
Galina Ryabykina,
Sergey Boytsov,
Abram Syrkin,
Hugo Saner,
Philipp Kopylov
Affiliations
Daria Gognieva
Researcher, World-Class Research Center ‘Digital biodesign and personalized healthcare’ I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
Nelly Vishnyakova
Head of Department, The state budgetary institution of health care of the Moscow region ‘Mytishchi city clinical hospital’, Mytishchi
Yulia Mitina
Department of Physiology, School of Biomedical Sciences, University of Melbourne, Melbourne
Petr Chomakhidze
Professor, World-Class Research Center ‘Digital biodesign and personalized healthcare’ I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
Dinara Mesitskaya
Assistant Professor, Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
Natalia Kuznetsova
Researcher, World-Class Research Center ‘Digital biodesign and personalized healthcare’ I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
Mohamed Khiari
Graduate Student, Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
Galina Ryabykina
Professor, Department of new research methods, Federal State budget organization National medical research center of cardiology of the Ministry of healthcare of the Russian Federation, Moscow
Sergey Boytsov
Department of new research methods, Federal State budget organization National medical research center of cardiology of the Ministry of healthcare of the Russian Federation, Moscow
Abram Syrkin
Professor, Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
Hugo Saner
Professor, Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, RU; ARTORG Center for Biomedical Engineering Research, University of Bern, Bern
Philipp Kopylov
Professor, World-Class Research Center ‘Digital biodesign and personalized healthcare’ I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow
Background: Screening for atrial fibrillation has the potential to significantly reduce cardiovascular morbidity and mortality. However, questions in regard to how to screen, on whom to screen, and the optimal setting of screening remain unanswered. Objective: To assess the applicability of a federal cardiac monitoring for atrial fibrillation (AF) screening and remote heart rhythm monitoring in patients at high cardiovascular risk in a mixed urban and rural population in Russia. Methods: This is a prospective multicenter cohort study including 3249 individuals with high cardiovascular risk (mean age 56 ± 12.8 years) from the larger Moscow region who were screened for AF using a smartphone-case based single-lead ECG monitor over a period of 18 month. The endpoints were considered as number of newly diagnosed AF; mean time to diagnosis; number of patients for the first time assigned to anticoagulation therapy; frequency of adverse events. Results: A trial fibrillation was diagnosed in 126 patients, 36 of them for the first time. The mean time to diagnosis was 3 ± 2 days. Of 36 patients, the CHA2DS2-VASc score was ≥1 in 34 cases, ≥2 in 29 cases. Anticoagulant therapy was first induced in 31 patients. One death in newly diagnosed group and two deaths in chronic group were registered. There were a total of eight hospitalizations: one in newly diagnosed and seven in chronic AF patients. Conclusion: Our results indicate that a Federal AF screening system in patients at high cardiovascular risk by using a smartphone-case based single lead ECG which is supported by centrally located ECG specialist and central data management is feasible and reliable when performed in a mixed urban and rural area. Further studies are needed to evaluate the full potential of this approach.
