The arsenal of atrial fibrillation (AF) screening tools continues to expand due to the rapid advancement of mobile health technologies.¹ Despite the lack of clinical validation of many of these tools, their usage is justified by their responsiveness and reliability in AF detection.¹ A prime example of these AF screening tools is MyDiagnostick (Applied Biomedical Systems BV, Maastricht, The Netherlands), which allows users to record a single-lead electrocardiography (ECG) by holding the electrodes on both ends of the device.² A previous study conducted in Belgium has concluded that MyDiagnostick exhibited exceptional AF diagnostic accuracy, with sensitivity and specificity of 94% and 93%, respectively.² Nevertheless, the effectiveness of MyDiagnostick has yet to be validated among the Asian population, hence, a  recent study was conducted to investigate its performance in the Asian general population.³

A prospective single-center study was conducted to evaluate the reliability of MyDiagnostick in AF screening among the Asian population.³ A total of 671 patients were recruited for AF screening, with Chinese participants making up the majority (79%), followed by Malaysians (7%) and Indians (11%).³ The participants first completed a questionnaire, then underwent a manual pulse check for at least 15 seconds.³ Subsequently, they were screened with MyDiagnostick.³ Confirmatory single-lead ECG was performed on participants who got an abnormal result during manual pulse check or MyDiagnostick screening.³ The primary objective of this study was to assess the diagnostic accuracy of MyDiagnostick against manual pulse checks in a low-risk Asian population, while the secondary objective was to identify the characteristics of participants with detected AF.³

The results indicated an AF prevalence rate of 1.78% among the study population, with 50% of these participants being newly diagnosed.³ MyDiagnostick showed a sensitivity of 100%  (95% CI: 73.5%-100.0%) and a specificity of 96.2% (95% CI: 94.6%-97.6%).³ However, out of the participants who obtained an abnormal MyDiagnostick result (n=37), only 32.4% (95% CI:  24.6%-41.3%) of participants were diagnosed with AF after undergoing confirmatory single-lead ECG.³ In comparison, manual pulse checks had a sensitivity of 83.3% (95% CI: 51.3%-97.9%) and specificity of 98.9% (95% CI: 97.8%-99.5%), with a positive  predictive value (PPV) of 58.8% (95% CI: 39.5%-75.6%).³ Despite the observable difference in sensitivity, specificity and PPV between the 2 screening methods, a statistical significance was not established owing to the limited sample size^.3

In this study, serval characteristics were observed among the  participants with AF.³ They were generally older (72.0 ± 11.7 vs.  56.0 ± 13.0; p<0.0001) and had a relatively higher CHADSVASC risk score (2.9 ± 1.5 vs. 1.5 ± 1.1; p=0.0001).³ The higher CHADSVASC risk scores were likely attributed to the higher prevalence of  hypertension among participants with AF (66.0% vs. 33.0%; p=0.016).³

To conclude, MyDiagnostick exhibited exemplary sensitivity and specificity in AF detection among the Asian populations, which is comparable to other related studies performed in different population cohorts.³ Despite a numerically lower PPV compared with a manual pulse check, MyDiagnostick can be performed by non-medical personnel.³ As such, this makes MyDiagnostick an ideal screening tool for primary care settings, also allowing similar AF screenings to be performed in clinics.³