Atrial Fibrillation (AF) is an abnormal heart rhythm and a major cause of stroke. Many are unaware they have this rhythm and those with certain conditions are at higher risk. Although GPs are funded to establish and maintain a register of those with the condition, it is not always easy to identify these patients in primary care. Identification of those with the condition is a Heart Improvement Plan Priority (Scottish Government 2014).
Through Scottish Government Improvement Funding a collaborative team comprising NHS Lothian, Digital Health Institute (DHI), SCTT and Alivecor are working to trial the use of the AliveCor ECG App at scale in primary care . Alivecor have several ongoing trials worldwide however, this is the biggest screening trial using digital technology carried out worldwide to date.
As stated above it is known there is a higher prevalence of AF in patients with certain long-term conditions, these include heart failure, diabetes and renal disease. Using this simple App, which provides quick, effective ECG readings, patients are being tested when attending their practice for their annual long-term condition review.
Although the App is able to diagnose effectively, the results in this trial are being streamed to local cardiology teams, who are also verifying diagnosis. It is hoped to identify the yield of patients who might otherwise not be diagnosed using current methods and to agree one national assessment tool for AF in Scotland.
The DHI has funded a full economic review to identify savings from strokes avoided as well as required medication costs to prevent stroke.
The clinical lead for this development is Dr Neil Grubb, Consultant Cardiologist,