Physicians' Academy for Cardiovascular Education

Self-applied ECG patch improves the rate of AF diagnosis

A Digital End-to-End, Nationwide, Pragmatic Trial of Screening for Undiagnosed Atrial Fibrillation Within a Health Insurance System Using a Self-Applied ECG Patch: Primary Results of the mHealth Screening to Prevent Strokes (mSToPS) Trial

Presented at ACC.18 by Steven Steinhubl (La Jolla, CA, USA)

News - Mar. 11, 2018


The lifetime risk of atrial fibrillation (AF) in adults >55 years is >37%, which is associated with a 5-fold increase in risk for stroke. Once AF is recognized, anticoagulation therapy can reduce the risk of stroke by 65% and mortality by 30%. Guideline-recommended opportunistic screening for AF is rarely done. Novel digital technologies do exist, but the clinical value and optimal method is currently unknown.

Therefore, the mHealth Screening to Prevent Strokes (mSToPS) trial was developed to determine if patient-generated data available through a wearable ECG patch can improve the identification of AF relative to routine care.

2655 eligible individuals without a diagnosis of AF were enrolled via a web-based platform to undergo active monitoring at home with an iRhythm Zio patch for an average of 12 days (cases) and for each case, 2 age-, sex- and CHA2DS2-VASc-matched observational controls were chosen. The primary endpoint was the number of participants with first diagnosis of AF at 1 year.

Main results


In a digital clinical trial with patient-generated data, use of a wearable ECG patch showed an improvement in the rate of AF diagnosis compared to routine care. Follow-up is needed to understand the clinical impact of ECG monitoring.

In a press release dr. Steinhubl said: “In most cases, the only currently recommended method is to feel someone’s pulse or check an ECG for 30 seconds during a routine doctor’s visit. Based on our data, individuals have very short episodes of AF that would make it very difficult to catch in the way we routinely look for it today.”


Our coverage of ACC.18 is based on the information provided during the congress.

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