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AF and Stroke 2020

How a smartphone may help prevent strokes

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Professor Martin R Cowie

Professor of Cardiology, Imperial College London (Royal Brompton Hospital) and Trustee, Atrial Fibrillation Association

Every year, the phone in our pockets can do more: but did you know it might also help reduce your chance of a stroke?


Atrial fibrillation (AF) is a heart rhythm problem that sadly can go unnoticed until you suffer a stroke. A stroke is caused by a small clot forming inside the heart and then shooting off to damage your brain.

Doctors have been trying for many years to pick up this irregular heart rhythm as early as possible as, once AF is detected, it may be reversible.

For decades the only way to record a tracing of your heartbeat – an electrocardiogram (ECG) – was to go to your GP or a hospital to be wired up to a machine.

But this lack of access could result in unreliable data. Sometimes, AF can be intermittent. During your ECG appointment your heart could (temporarily) go back to normal rhythm and false reassurance might then be given.

Smart phones and watches help identify AF

Last year, the Apple Heart study was published, where more than 400,000 people who had an Apple Watch volunteered to see if the irregular pulse alarm could help identify those with AF. The results were promising: (although many of the volunteers were young and therefore not very likely to have AF) many potential cases were identified, and most were confirmed on further testing.

More recent versions of the Apple Watch now can record a simple ECG for the wearer to email to their doctor. The watch is not sold as a diagnostic device, but this may well be a useful added benefit.

Technology does indeed appear to be our friend. But, it is important to remember that even where technology is not available, a simple ‘pulse check’ with someone learning to feel their pulse (and that of their family and friends) can flag up issues too.

The smartphone has also proven to be a boon for the detection of AF. The Kardia/AliveCor device is a small metal plate that fits on the back of a smartphone and records a simple ECG.

Studies in the UK and elsewhere show impressive ability to identify people who did not know they had AF.

A large GP-based study in Cambridge is currently examining whether this approach might reduce strokes if a similar technology is ‘prescribed’ for patients for a few weeks.

Even your smartphone camera and light may be able to help: an app, (Fibricheck) has been developed to detect AF by examining the pulse in your fingertip.

If ongoing studies work out, then this might be an even simpler way to ensure everyone can quickly check their pulse from time to time.

Healthcare professionals and patients embrace new tech

Doctors, along with the patient charity, Atrial Fibrillation Association and Arrhythmia Alliance, have welcomed any attempt to improve AF detection.

Technology does indeed appear to be our friend. But, it is important to remember that even where technology is not available, a simple ‘pulse check’ with someone learning to feel their pulse (and that of their family and friends) can flag up issues too.

Professor Martin R Cowie is Professor of Cardiology at Imperial College London (Royal Brompton Hospital) and is a Trustee of the Atrial Fibrillation Association. He has no financial interest in any of the technologies mentioned in this article.

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