Introduction

Diagnostic pathways for identification of clinically significant paroxysmal arrhythmia have historically relied on ambulatory ECG monitoring. While useful as a risk stratification tool in certain patient groups, in general, it has a limited yield for infrequent arrhythmia. This is inherently cost-inefficient, and time to diagnosis can be delayed. Smartphone-based ECG devices are now well established in the public market. However, their adoption into standard investigatory pathways is not yet widespread. Recently, the National Institute for Health and Care Excellence (NICE) published a diagnostics guidance document, which reviewed the smartphone-based devices, AliveCor Kardia and imPulse, with respect to atrial fibrillation (AF) detection. NICE concluded there was insufficient evidence to recommend routine adoption in primary care and recommended further research.1 Regardless, given the evidence that is available and their uptake by the general public, cardiologists are increasingly likely to encounter them. This article will focus on the AliveCor Kardia as the device is currently easily available to the general public.