- Researchers in New York are launching an mHealth program to determine whether a tablet with an embedded video recording app can detect atrial fibrillation.
A team of engineers and clinicians at the Rochester Institute of Technology and the University of Rochester Medical Center is using a $2 million National Institutes of Health grant to test the mHealth app on about 260 patients.
The study will focus on whether a video algorithm in the app can surreptitiously asses AF in someone using the tablet. As part of the study, users will also wear an ECG patch, so that researchers can compare the two sensing platforms.
“Our technology is unique because it requires no action on the part of the user aside from what they normally do – go on a tablet to shop, look at pictures, read articles, or whatever they like,” Jean Philippe Couderc, a biomedical engineer and assistant director of UR’s Heart Research Follow-up Program Lab, who will lead the study, said in a press release. “If you are at risk for [AF], you install it on your tablet or phone and don’t think about it anymore.”
Up until now, much of the mHealth research done on AF – the most common abnormal heart rhythm, responsible for one-third of all strokes - has focused on moving from expensive, hospital-based tests and cumbersome monitors to wireless patches and wearables, such as smartwatches.
While AF is very difficult to detect during one’s annual visit to the doctor’s office, physicians who have access to ECGs on a daily basis stand a much better chance of spotting the condition and treating it before it causes a stroke.
"If more patients with atrial fibrillation can be detected, then more patients can receive appropriate stroke prevention therapy, and the hope is that more strokes, deaths, disability and dementia can be avoided," David Gladstone, a professor at the University of Toronto, told the New York Times in 2014. Gladstone was the lead researcher in a study that found that AF was diagnosed in five times as many patients who were monitored regularly for 30 days, as opposed to the 24-hour time window used in in-patient sessions.
In fact, studies using wearable monitors helped convince the American Medical Association in 2014 to change its guidelines to indicate that it’s “reasonable” to expect healthcare providers to monitor for AF over a 30-day period, rather than 24 hours.
While much of the research focuses on making the patient an active participant in monitoring, the RIT/RUMC will study whether digital health technology can capture biometric data independent of user participation.
“We have shown that the technology developed at RIT is reliable enough to be used as a clinical tool in controlled hospital environments,” Gill Tsouri, an associate professor of electrical engineering at RIT’s Kate Gleason College of Engineering, who is developing the video system algorithm and app, said in the press release. “Our purpose now is to make it more accessible and more useful in everyday life. The end goal of all of this is to show that it is a clinically viable approach, which means that seamlessly capturing videos without user participation provides significant data that could be used to deduce their cardiac condition.”
The video recording app will be installed on the tablet and will run seamlessly in the background while the tablet is used. During that time, the software records the user’s heart rhythm.
The researchers emphasized that the app won’t replace EKG/ECG tests that use contact sensors to measure the heart’s electrical activity, but they can replace the PPG, a pulse plethysmograph that illuminates the skin and measures the volume changes in blood during a heartbeat.
“The advantages of this technology are, it does not require participation from the subject being monitored, and it can provide us with vast amounts of data,” Tsouri said. “We are moving from monitoring a person for 30 seconds once-a-year to a few hours a day.”
“One of the biggest focus of this grant is Silent Atrial Fibrillation,” he added. “Silent AF might go undetected for many years, but it is a serious condition, and if you know about it in advance you can help improve a patient’s health.”