iPhone ECG application for community screening to detect silent atrial fibrillation: A novel technology to prevent stroke

Lau, Joseph; Lowres, Nicole; Neubeck, Lis; Brieger, David; Sy, Raymond W.; Galloway, Connor; Albert, David E.; Freedman, Ben

doi:10.1016/j.ijcard.2013.01.220

Cited by 309 publications

(274 citation statements)

References 4 publications

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“…The AliveCor heart monitor (AliveCor, San Francisco, CA) is a Food and Drug Administration–approved handheld single‐lead ECG device attached to a smartphone with an AF detection application. Initial validation study of the AliveCor for AF detection has shown high sensitivity of 98% and specificity of 97% 13. However, the diagnostic performance of the AliveCor as a screening test in a “real‐world” primary care setting was lower, with sensitivity of 98% (95% confidence interval [CI], 92%–100%) and specificity of 91% (95% CI, 89%–93%) in the SEARCH‐AF (Screening Education And Recognition in Community pHarmacies of Atrial Fibrillation) study using the same algorithm 12…”

Section: Introductionmentioning

confidence: 99%

Contact‐Free Screening of Atrial Fibrillation by a Smartphone Using Facial Pulsatile Photoplethysmographic Signals

Yan

Lai

Chan

et al. 2018

JAHA

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BackgroundWe aimed to evaluate a novel method of atrial fibrillation (AF) screening using an iPhone camera to detect and analyze photoplethysmographic signals from the face without physical contact by extracting subtle beat‐to‐beat variations of skin color that reflect the cardiac pulsatile signal.Methods and ResultsPatients admitted to the cardiology ward of the hospital for clinical reasons were recruited. Simultaneous facial and fingertip photoplethysmographic measurements were obtained from 217 hospital inpatients (mean age, 70.3±13.9 years; 71.4% men) facing the front camera and with an index finger covering the back camera of 2 independent iPhones before a 12‐lead ECG was recorded. Backdrop and background light intensity was monitored during signal acquisition. Three successive 20‐second (total, 60 seconds) recordings were acquired per patient and analyzed for heart rate regularity by Cardiio Rhythm (Cardiio Inc, Cambridge, MA) smartphone application. Pulse irregularity in ≥1 photoplethysmographic readings or 3 uninterpretable photoplethysmographic readings were considered a positive AF screening result. AF was present on 12‐lead ECG in 34.6% (n=75/217) patients. The Cardiio Rhythm facial photoplethysmographic application demonstrated high sensitivity (95%; 95% confidence interval, 87%–98%) and specificity (96%; 95% confidence interval, 91%–98%) in discriminating AF from sinus rhythm compared with 12‐lead ECG. The positive and negative predictive values were 92% (95% confidence interval, 84%–96%) and 97% (95% confidence interval, 93%–99%), respectively.ConclusionsDetection of a facial photoplethysmographic signal to determine pulse irregularity attributable to AF is feasible. The Cardiio Rhythm smartphone application showed high sensitivity and specificity, with low negative likelihood ratio for AF from facial photoplethysmographic signals. The convenience of a contact‐free approach is attractive for community screening and has the potential to be useful for distant AF screening.

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Section: Introductionmentioning

confidence: 99%

Contact‐Free Screening of Atrial Fibrillation by a Smartphone Using Facial Pulsatile Photoplethysmographic Signals

Yan

Lai

Chan

et al. 2018

JAHA

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“…The rhythm is labeled as "unreadable" when the detector indicates there was too much interference for an adequate recording, whether from too much movement, or poor contact between the electrodes and the patient's skin. The rhythm is labeled as "Possible AF Detected" when the device detects the presence of AF, and has been shown to do so with 98% sensitivity and 97% specificity when comparing it with a contemporaneous 12-lead ECG interpreted by a cardiologist [8]. AliveCor notes that this device provides data and is not capable of making a diagnosis of AF.…”

Section: Smartphone Technologymentioning

confidence: 99%

“…The accuracy of the AliveCor device has been investigated by multiple studies [8][9][10]. The sensitivity and specificity of the AliveCor device was assessed by Lau et al [8].…”

Section: Smartphone Studiesmentioning

confidence: 99%

Smartphone-based arrhythmia detection: Should we encourage patients to use the ECG in their pocket?

White¹,

Flaker²

2017

Cardiovasc Disord Med

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“…In Poland, PDAs were used to collect data for a national survey on current tobacco use among adults [17] . In diagnostics, a quick and easy diagnosis of atrial fibrillation with an iPhone application, which records a high quality single lead of ECG, is a promising novel technology [24,25] . Electronic decision support tools are very useful in screening and identifying individuals at a high risk of developing a disease to appropriately manage this risk.…”

Section: Modes Of Mhealth Deliverymentioning

confidence: 99%

m-Health in Coronary Disease Preventive Care

Santo

Chalmers

Chow

et al. 2015

Journal of Cardiology and Therapy

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iPhone ECG application for community screening to detect silent atrial fibrillation: A novel technology to prevent stroke

Cited by 309 publications

References 4 publications

Contact‐Free Screening of Atrial Fibrillation by a Smartphone Using Facial Pulsatile Photoplethysmographic Signals

Contact‐Free Screening of Atrial Fibrillation by a Smartphone Using Facial Pulsatile Photoplethysmographic Signals

Smartphone-based arrhythmia detection: Should we encourage patients to use the ECG in their pocket?

m-Health in Coronary Disease Preventive Care

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