In keeping with a study from Duke Clinical Research Institute, portable, long-term heart monitors helped detect 52% more cases of atrial fibrillation compared with standard care, but this didn’t result in a discount in hospitalizations for stroke.

The outcomes, presented on 1 September on the meeting of the European Society of Cardiology and published within the journal Journal of the American College of Cardiology, provide inconsistent data on whether screening for atrial fibrillation reduces stroke rates. The COVID pandemic caused the study to be stopped early before full recruitment, so there have been not enough participants to find out definitive stroke outcomes.

“Atrial fibrillation often goes undiagnosed and should increase the chance of ischemic stroke, which is basically reversible with oral anticoagulants,” said study lead creator Renato Lopes, MD, professor of medication and member of the Duke Clinical Research Institute.

We still need definitive evidence that diagnosis of atrial fibrillation through systematic screening can result in subsequent treatment with oral anticoagulants and thus reduce the chance of stroke.”

Renato Lopes, Professor of Medicine, Duke Clinical Research Institute

The study involved about 12,000 patients within the U.S. who were at the very least 70 years old and had no history of atrial fibrillation. About half of the patients were randomly assigned to receive a long-term (14 days) continuous monitoring device and the opposite half to receive standard care.

Over 15 months of follow-up, the study found a 52% increase within the variety of atrial fibrillation cases diagnosed in people wearing the device compared with those receiving standard care. There was no increase in hospitalizations for bleeding and no significant reduction in hospitalizations for all strokes compared with standard care.

The study was originally designed to incorporate 52,000 patients, which might give it the power to find out whether screening reduces strokes. A big study population is required because strokes occur in a subset of patients with atrial fibrillation.

“Despite the mixed results, we learned so much that might inform future research,” Lopes said. He said the study design, which allowed patients to enroll and screen online in a virtual format using self-administered patches of their homes, using only distant support, might be replicated in future studies.

Along with Lopes, study authors include Steven J. Atlas, Alan S. Go, A. Lubitz, David D. McManus, Rowena J. Dolor, Ranee Chatterjee, Michael B. Rothberg, David R. Rushlow, Lori A. Crosson, Ronald S. Aronson, Michael Patlakh, Dianne Gallup, Donna J. Mills, Emily C. O’Brien and Daniel E. Singer.