Home-Based ECG Monitoring Enhances Detection of Atrial Fibrillation

Recent research led by Oxford Population Health highlights the benefits of using a wearable electrocardiogram (ECG) patch for the detection of atrial fibrillation (AF), a prevalent but often undiagnosed heart rhythm disorder that significantly increases the risk of stroke and heart failure. The study, known as the AMALFI trial, demonstrated that remote, home-based AF screening can modestly improve diagnosis rates and lead to earlier treatment adjustments.

The trial involved 5,040 participants aged 65 and older with known stroke risk factors. Participants were randomly divided into two groups: one group wore a two-week ECG patch (iRhythm Zio XT) alongside their usual care, while the control group received standard care without monitoring. Over a follow-up period of 2.5 years, the results showed that 6.8% of those who used the monitoring patch were diagnosed with AF, compared to 5.4% in the control group, indicating a statistically significant increase in detection.

Importantly, AF was diagnosed earlier in the monitored group, with a median detection time of 103 days versus 530 days in the control group. The study also found that individuals who wore the ECG patch were more likely to be prescribed anticoagulant medications—averaging 1.63 months of use compared to 1.14 months in the usual care group. Nearly half of the detected AF episodes occurred on the very first day of tracking, demonstrating the device's effectiveness in capturing early arrhythmia episodes.

While the stroke rates were similar between groups—2.7% in the screening group and 2.5% in the control group—the study emphasized that its primary focus was on detection and treatment initiation rather than direct stroke prevention. Dr. Rohan Wijesurendra, lead author, noted that remote ECG monitoring can be a valuable tool for identifying AF in high-risk older adults, though further research is needed to determine its impact on stroke reduction and overall cost-effectiveness.

This completely remote study utilized mailing of the monitoring devices, which participants self-applied, integrated into their daily routines, and then returned for analysis. Professor Louise Bowman pointed out that modern technology allows for longer-duration screening that can detect infrequent or short episodes of AF that might otherwise go unnoticed. Experts believe that integrating such remote, home-based monitoring approaches could transform AF detection, enabling timely interventions to reduce stroke risk and improve patient outcomes.

For more details, see the full study published in the American Heart Journal. Source: https://medicalxpress.com/news/2025-08-home-based-heart-rhythm-screening.html