RT Journal Article
SR Electronic
T1 NICE atrial fibrillation guideline snubs wearable technology: a missed opportunity?
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 77
OP 82
DO 10.7861/clinmed.2021-0436
VO 22
IS 1
A1 Andre Briosa e Gala
A1 Michael TB Pope
A1 Milena Leo
A1 Trudie Lobban
A1 Timothy R Betts
YR 2022
UL http://www.rcpjournals.org/content/22/1/77.abstract
AB Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a growing public health epidemic. In the UK, over 1.3 million people have a diagnosis of AF and an estimated 400,000 remain undiagnosed. AF-related strokes account for a quarter of all strokes and, as AF episodes are often asymptomatic, are still often the first manifestation of AF. Early diagnosis and initiation of oral anticoagulation, where appropriate, may prevent some of these thromboembolic strokes. Public Health England is committed to decrease the incidence of AF-related strokes and has sponsored initiatives aimed at improving AF detection by promoting the uptake of wearable technologies. However, the National Institute for Health and Care Excellence (NICE) has not recommended wearable technology in their recent AF diagnosis and management guidelines (NG196). Diagnostic accuracy of single-lead electrocardiography (ECG) generated by the latest iteration of wearable devices is excellent and, in many cases, superior to general practitioner interpretation of the 12-lead ECG. High-quality ECG from wearable devices that unequivocally shows AF can expedite AF detection. Otherwise, there is a real risk of delaying AF diagnosis with the potential of devastating consequences for patients and their families.