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Clinical Articles, Lead Article

Thumb-based ECG detects silent AF in stroke patients

Regular screening using a handheld electrocardiology (ECG) device on 75-year-old stroke patients for detecting silent atrial fibrillation (AF) is both effective and provides long-term cost savings, according to a new clinical study published in Europace.1

The device used was a thumb-ECG (Zenicor) on which patients record their own ECG twice daily for 30 days. The study also compared intermittent recordings on the thumb-ECG device with ambulatory continuous 24 hour Holter-ECG recording. The 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.”

Screen shot 2014-10-31 at 12.30.00The 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.


1. Levin LA, Husberg M, Sobocinski PD, et al. A cost-effectiveness analysis of screening for silent atrial fibrillation after ischaemic stroke. Europace 2014.

Published on: October 31, 2014

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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