Using a smartphone app to monitor heart rhythm may help patients with atrial fibrillation (AFib) take blood-thinning drugs only as needed, according to a new pilot study conducted by researchers from the Perelman School of Medicine at the University of Pennsylvania.
They presented their study findings last week at the Heart Rhythm Society’s annual meeting in San Francisco and are preparing a manuscript for publication.
Patients with atrial fibrillation often take daily oral anticoagulation medications, such as warfarin, to prevent blood clotting and stroke. Regular use of these drugs may have adverse effects, though.
According to the researchers, novel anticoagulants (NOACs) for AFib prescribed on an “as-needed” basis and guided by diligent pulse monitoring can lower overall risk of stroke.
The study involved 100 AFib patients, ages 45-78, with significant stroke risk. The subjects were prescribed NOACs, but instructed to avoid taking the drugs unless they suspected or detected an AFib episode lasting 1-2 hours.
All patients checked their pulse twice daily, including nine who monitored their heart rhythm with a smartphone-enabled device.
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Electrodes embedded in a smartphone case were connected via low-energy Bluetooth technology to a smartphone app, explained co-author Dr. Francis Marchlinski, director of electrophysiology for the University of Pennsylvania Health System. By placing their fingers on the electrodes, patients were able to record their heart rhythm when experiencing symptoms that persisted long enough to activate the application.
In case of any abnormality or unexpected finding, the app is able to send the recordings to a physician’s office for more detailed review. “In a study after AF ablation, the technology has been compared to transtelephonic monitor ECGs and appears as effective in detecting atrial fibrillation/flutter,” Marchlinski said.
In the research study, the team followed the participant for approximately 23 months, during which time 28 patients started taking the blood thinner at least once for a suspected or detected AFib episode.
Only 10 patients transitioned back to chronic oral anticoagulation therapy for recurrent AFib. There was one mild bleeding incident that required medical attention, but no patient experienced a stroke or transient ischemic attack.
“These are patients who were actively seeking, preparing for and are committed to the alternate treatment method, and who are informed about how to diligently and effectively monitor their pulse throughout the day,” said lead author Monica Pammer. Pammer, a physician assistant in electrophysiology at the Hospital of the University of Pennsylvania, said that this approach to anticoagulation therapy requires communication between the patient and the care team.
Photo: Flickr user Janitors
