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. 2022 May;111(5):479-491.
doi: 10.1007/s00392-021-01941-9. Epub 2021 Sep 21.

Mobile health solutions for atrial fibrillation detection and management: a systematic review

Astrid N L Hermans #  1 , Monika Gawalko #  1   2   3 , Lisa Dohmen  1 , Rachel M J van der Velden  1 , Konstanze Betz  1 , David Duncker  4 , Dominique V M Verhaert  1   5 , Hein Heidbuchel  6   7 , Emma Svennberg  8 , Lis Neubeck  9 , Jens Eckstein  10 , Deirdre A Lane  11 , Gregory Y H Lip  11 , Harry J G M Crijns  1 , Prashanthan Sanders  12 , Jeroen M Hendriks  12   13 , Nikki A H A Pluymaekers  1 , Dominik Linz  14   15   16   17
Affiliations

Mobile health solutions for atrial fibrillation detection and management: a systematic review

Astrid N L Hermans et al. Clin Res Cardiol. 2022 May.

Abstract

Aim: We aimed to systematically review the available literature on mobile Health (mHealth) solutions, including handheld and wearable devices, implantable loop recorders (ILRs), as well as mobile platforms and support systems in atrial fibrillation (AF) detection and management.

Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The electronic databases PubMed (NCBI), Embase (Ovid), and Cochrane were searched for articles published until 10 February 2021, inclusive. Given that the included studies varied widely in their design, interventions, comparators, and outcomes, no synthesis was undertaken, and we undertook a narrative review.

Results: We found 208 studies, which were deemed potentially relevant. Of these studies included, 82, 46, and 49 studies aimed at validating handheld devices, wearables, and ILRs for AF detection and/or management, respectively, while 34 studies assessed mobile platforms/support systems. The diagnostic accuracy of mHealth solutions differs with respect to the type (handheld devices vs wearables vs ILRs) and technology used (electrocardiography vs photoplethysmography), as well as application setting (intermittent vs continuous, spot vs longitudinal assessment), and study population.

Conclusion: While the use of mHealth solutions in the detection and management of AF is becoming increasingly popular, its clinical implications merit further investigation and several barriers to widespread mHealth adaption in healthcare systems need to be overcome. Mobile health solutions for atrial fibrillation detection and management: a systematic review.

Keywords: Atrial fibrillation; Systematic review; mHealth.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Presentation of mobile health devices and their sensitivity and specificity considering 12-lead electrocardiogram as the gold standard. This figure summarizes the literature as performed in this systematic review. Sensitivity and specificity range were given when an mHealth solution was clinically validated by > 1 study. *Single-lead electrocardiogram as the gold standard; **24-h Holter monitoring as the gold standard. ECG electrocardiography, MCG mechanocardiography, PPG photoplethysmography
Fig. 2
Fig. 2
Flow diagram for study selection process
Fig. 3
Fig. 3
Type of mobile health solutions for atrial fibrillation detection and management. *Numbers do not add up to 82 as 4 studies assessed in parallel PPG- and ECG-based device, **numbers do not add up to 208 as 3 studies assessed in parallel handheld device with mobile platforms/support systems (n = 1) and wearable devices (n = 2). AF atrial fibrillation, CDSS clinical decision system support, ECG electrocardiography, MCG mechanocardiography, mHealth mobile health, PPG photoplethysmography
See this image and copyright information in PMC

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