Swedish study shows Thumb-ECG self monitoring by stroke patients cuts risks of silent atrial fibrillation
A new clinical study published in Europace, shows that regular screening using a handheld-ECG device on 75-year-old stroke patients for detecting silent atrial fibrillation (AF) is both effective and provides longterm cost savings. The device used was the Zenicor thumb-ECG on which patients record their own ECG twice daily for 30 days. The study also compared intermittent recordings on the Zenicor thumb-ECG device with ambulatory continuous 24 h Holter-ECG recording. The Zencior thumb-ECG method showed both higher sensitivity and lower costs compared to the Holter-ECG method.
The purpose of the study was to estimate the cost-effectiveness of two screening methods for detection of silent AF in comparison with a no-screening alternative in 75-year-old patients with a recent ischaemic stroke. The base-case analysis compared intermittent ECG screening with no screening of patients with recent stroke. The implementation of the screening programme on 1000 patients resulted over a 20-year period in 11 avoided strokes and the gain of 29 life-years, or 23 quality-adjusted life years, and cost savings of €55,400.
Lars-Åke Levin, Principal investigator in the study commented: “By using a decision analytic model, we have shown that screening of recent stroke patients by handheld ECG recording is highly cost-effective and after 7 years even leads to cost savings. The explanation for this is a relatively low-cost screening technology in combination with a high-risk target population and effective and cost-effective anti-coagulant treatments.”
The device used in the study, thumb-ECG allows the patient to register ECG data over extended periods – several times daily and when symptoms are experienced – and transfer the data to a central ECG database, where the data is presented to the care provider via the internet. The device is currently used in over 250 clinics in Sweden and the other Nordic countries.
Mats Palerius, CEO of Zenicor added: “We are very excited about the results of this study since it demonstrates that screening of this patient category not only lowers the risk for another stroke in identified patients, but that it also shows that the screening is cost-effective. The publication provides additional clinical evidence, thereby further strengthening our current clinical documentation. At the same time, the results strengthen our ongoing IPO process on the Stockholm Stock Exchange, which will finance further geographical expansion.”
A cost-effectiveness analysis of screening for silent atrial fibrillation after ischaemic stroke, Lars-Åke Levin, Magnus Husberg, Piotr Doliwa Sobocinski, Viveka Frykman Kull, Leif Friberg, Mårten Rosenqvist, and Thomas Davidson, Europace, doi:10.1093/europace/euu213, published online 27 October 2014.