• atrial fibrillation
• electrocardiography
• eHealth/telemedicine/mobile health

Atrial fibrillation (AF), estimated to be present in over 30 million people worldwide as of 2010, is expected to increase by 2030 and one in four adults in Europe and the USA will likely develop AF over their lifetime.1 Although anticoagulation has been demonstrated to reduce stroke in patients with AF, stroke may be the first manifestation of AF in up to 25% of patients with AF.2 Screening for AF in vulnerable patients has been recommended.1

Arguably, the modern era of wearable technology was ushered in by the availability of Bluetooth technology in 2002 and has included products made by Garmin, Nike, Fitbit, Google and others over the ensuing decade.3 Industry projections estimate that, by 2020, more than 305 million units will be sold with an annual growth rate of over 55%.

One company at the intersection of electrocardiography and portable technology has been AliveCor (Mountain View, California, USA), the makers of the product used in this study. In 2012, AliveCor received Food and Drug Administration (FDA) 510(k) clearance and CE Mark conformity for using its KardiaMobile product by licensed medical professionals.4 In 2013, doctors were able to prescribe these monitors to patients, and in early 2014, the devices became available for over-the-counter purchase. By late 2014, the FDA granted clearance for the device’s algorithm to detect AF, thereby offering users real-time identification of this arrhythmia. In 2015, the automated algorithms were updated to include ‘normal’ and ‘interference’, in addition to AF. In 2017, the KardiaBand was introduced as an accessory to the Apple Watch to allow users to record ECGs from a wristband and an application on the watch. In 2019, however, AliveCor stopped selling KardiaBand. In April 2019, the FDA cleared the KardiaMobile …