Since atrial fibrillation (AF) may be asymptomatic and remain undiagnosed, the AMALFI study aimed to assess whether a remote screening program could increase AF detection and thereby improve the prevention of cerebrovascular events.
This was a multicenter, randomized, controlled clinical trial conducted across 27 primary care centers in the United Kingdom. A total of 5,040 participants were randomized into two groups: monitoring with a 14-day ambulatory ECG patch, or usual care (follow-up with a general practitioner, referrals, and routine testing only if symptoms appeared or clinical suspicion arose). The primary endpoint was AF detection at 2.5 years.
Results showed higher AF detection in the patch group compared with usual care: 6.8% (172/2520) vs 5.4% (136/2520) (p=0.03). Most episodes detected by the patch had a low AF burden (<10%). Regarding clinical outcomes, there were no significant differences in the incidence of stroke or death between groups during the follow-up period.
Read also: ESC 2025 | DUAL-ACS: Duration of Dual Antiplatelet Therapy in Acute Coronary Syndromes.
The authors concluded that remote screening with ambulatory ECG patches is feasible, leading to a significant increase in AF detection and anticoagulation use. However, its short-term impact on reducing stroke and mortality was limited.
Presented by Louise Bowman at Major Late Breaking Trials, ESC 2025, Madrid, Spain.
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