Cardiovascular Digital Health Journal (Jul 2020)

Survey of current perspectives on consumer-available digital health devices for detecting atrial fibrillation

  • Eric Y. Ding, MS,
  • Emma Svennberg, MD, PhD,
  • Christina Wurster, MBA,
  • David Duncker, MD,
  • Martin Manninger, MD, PhD,
  • Steven A. Lubitz, MD, MPH,
  • Emily Dickson, BS,
  • Timothy P. Fitzgibbons, MD, PhD,
  • Nazem Akoum, MD, MS, FHRS,
  • Sana M. Al-Khatib, MD, MHS, FHRS,
  • Zachi I. Attia, PhD,
  • Hamid Ghanbari, MD, MPH,
  • Nassir F. Marrouche, MD, FHRS,
  • G. Stuart Mendenhall, MD, FHRS,
  • Nicholas S. Peters, MD, FHRS,
  • Khaldoun G. Tarakji, MD, MPH, FHRS,
  • Mintu Turakhia, MD, MPH, FHRS,
  • Elaine Y. Wan, MD, FHRS,
  • David D. McManus, MD, ScM, FHRS

Journal volume & issue
Vol. 1, no. 1
pp. 21 – 29

Abstract

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Background: Many digital health technologies capable of atrial fibrillation (AF) detection are directly available to patients. However, adaptation into clinical practice by heart rhythm healthcare practitioners (HCPs) is unclear. Objective: To examine HCP perspectives on use of commercial technologies for AF detection and management. Methods: We created an electronic survey for HCPs assessing practice demographics and perspectives on digital devices for AF detection and management. The survey was distributed electronically to all members of 3 heart rhythm professional societies. Results: We received 1601 responses out of 73,563 e-mails sent, with 43.6% from cardiac electrophysiologists, 12.8% from fellows, and 11.6% from advanced practice practitioners. Most respondents (62.3%) reported having recommended patient use of a digital device for AF detection. Those who did not had concerns about their accuracy (29.6%), clinical utility of results (22.8%), and integration into electronic health records (19.8%). Results from a 30-second single-lead electrocardiogram were sufficient for 42.7% of HCPs to recommend oral anticoagulation for patients at high risk for stroke. Respondents wanted more data comparing the accuracy of digital devices to conventional devices for AF monitoring (64.9%). A quarter (27.3%) of HCPs had no reservations recommending digital devices for AF detection, and most (53.4%) wanted guidelines from their professional societies providing guidance on their optimal use. Conclusion: Many HCPs have already integrated digital devices into their clinical practice. However, HCPs reported facing challenges when using digital technologies for AF detection, and professional society recommendations on their use are needed.

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