Monitoring heart rhythm using a smartphone app may help patients with atrial fibrillation by letting them take blood-thinning drugs only as needed.
Atrial fibrillation involves having irregular heartbeat that can lead to serious outcomes. If the disorder is left unmanaged or uncontrolled, it could lead to blood clotting and stroke. This is the reason why patients with atrial fibrillation are prescribed with blood-thinning drugs or anticoagulants.
Taking Blood-Thinning Drugs
Blood-thinning drugs, of which warfarin is the most common example, are staples in atrial fibrillation management. While it is beneficial, regular intake of such drugs may lead to undesirable effects.
"The problem is that long-term use of anticoagulants is associated with an increased risk of bleeding," says study co-author Dr. Francis Marchlinski from the University of Pennsylvania Health System.
Minor bleeding may lead to a major, life-threatening event in life. Marchlinski explains that it is acceptable for patients not to take blood-thinning drugs if they do not need them.
Novel Anticoagulants
For the new study, the researchers focused on novel anticoagulants (NOACs), which are a new type of blood-thinning medication. Examples of NOACs include rivaroxaban, apixaban and dabigatran.
NOACs are said to work more rapidly than warfarin and can be prescribed to a larger population of patients, including those who have atrial fibrillation, which is not related to heart valve problems.
The Investigation
The study involved 100 patients aged 56 to 72 years old who were previously on daily NOAC treatments. None of them had prolonged signs of atrial fibrillation during the start of the study.
The participants checked their pulse rates twice during the day, with nine who monitored their heart rhythm using a smartphone app.
The participants were given NOACs under close collaboration with their doctors. They were instructed to avoid taking the drugs unless they think or were sure that they were having atrial fibrillation that would persist for one to two hours.
After 18 months, approximately one-quarter of the participants had to take NOAC at least once and only six of them had to resume daily NOAC treatment.
No one had stroke or mini-stroke and only one had a minor bleeding episode.
NOACs: Not For Everyone
NOACs are less associated with major bleeding, but are related to harder-to-treat bleeding. With this, they are considered inappropriate for all patients suffering from atrial fibrillation.
Marchlinski says this possible treatment is only recommended for patients who have undergone long periods of monitoring, are religious pulse rate takers who are able to detect their atrial fibrillation, and exhibit atrial fibrillation control as supported by electrocardiogram.
Such requirements testify how NOACs are not for everyone.
The authors note that their work is just a pilot study. Also, the findings have not yet been published in a peer-reviewed journal.
"While this is an observational study with a relatively small patient sample, further research is certainly needed to better understand alternate treatment options," says lead author Monica Pammer
The results of the study is set to be presented at the Heart Rhythm Society annual meeting.
