title: Feasibility of Using Mobile ECG Recording Technology to Detect Atrial Fibrillation in Low-Resource Settings.
abstract: Screening for atrial fibrillation (AF), a major risk factor for stroke that is on the rise in Africa, is becoming increasingly critical.
  
  
  
  This study sought to examine the feasibility of using mobile electrocardiogram (ECG) recording technology to detect AF.
  
  
  
  In this prospective observational study, we used a mobile ECG recorder to screen 50 African adults (66% women; mean age 54.3 ± 20.5 years) attending Kijabe Hospital (Kijabe, Kenya). Five hospital health providers involved in this study's data collection process also completed a self-administered survey to obtain information on their access to the Internet and mobile devices, both factors necessary to implement ECG mobile technology. Outcome measures included feasibility (completion of the study and recruitment of the patients on the planned study time frame) and the yield of the screening by the mobile ECG technology (ability to detect previously undiagnosed AF).
  
  
  
  Patients were recruited in a 2-week period as planned; only 1 of the 51 patients approached refused to participate (98% acceptance rate). All of the 50 patients who agreed to participate completed the test and produced readable ECGs (100% study completion rate). ECG tracings of 4 of the 50 patients who completed the study showed AF (8% AF yield), and none had been previously diagnosed with AF. When asked about continuous access to Internet and personal mobile devices, almost all of the health care providers surveyed answered affirmatively.
  
  
  
  Using mobile ECG technology in screening for AF in low-resource settings is feasible, and can detect a significant proportion of AF cases that will otherwise go undiagnosed. Further study is needed to examine the cost-effectiveness of this approach for detection of AF and its effect on reducing the risk of stroke in developing countries.
authors.affiliation: Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Grahame F
authors.initials: GF
authors.lastname: Evans
authors.affiliation: Emergency Pediatrics Clinic, AIC Kijabe Hospital, Kijabe, Kenya.
authors.forename: Arianna
authors.initials: A
authors.lastname: Shirk
authors.affiliation: Outpatient Internal Medicine Clinic, AIC Kijabe Hospital, Kijabe, Kenya.
authors.forename: Peter
authors.initials: P
authors.lastname: Muturi
authors.affiliation: Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: esoliman@wakehealth.edu.
authors.forename: Elsayed Z
authors.initials: EZ
authors.lastname: Soliman
mesh_terms: D001281:Atrial Fibrillation / Q000175:diagnosis*; D003362:Cost-Benefit Analysis; D003906:Developing Countries / Q000191:economics*; D004562:Electrocardiography / Q000191:economics* / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007630:Kenya; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies