Mobile single-lead ECG screening is feasible in routine inpatient and outpatient settings and identified a substantial prevalence of AF, which increased with age, though the absence of systematic confirmatory ECG testing and limited patient engagement with telemedicine applications highlight challenges in real-world implementation.
The mobile single-lead ECG device (AliveCor KardiaMobile) successfully provided an automated interpretation in 95.3% of outpatients and 85.6% of inpatients.
The device algorithm detected AF in 21.5% of the overall study cohort.
Newly suspected AF was identified in 1.7% of patients without a prior AF diagnosis.
Technical challenges occurred in 16.0% of all recordings, with a numerically higher rate in the inpatient setting compared to outpatients.
Patient engagement with telemedicine applications was very low, with only 6.3% of patients reporting regular use.
This was a multicenter, cross-sectional pragmatic implementation study enrolling both inpatients and outpatients across diverse healthcare settings.
This research examined whether a small, handheld heart rhythm device (AliveCor KardiaMobile) could realistically be used to screen patients for atrial fibrillation (AF) — an irregular heart rhythm that greatly increases the risk of stroke — in everyday hospital and clinic settings. The study enrolled 237 patients across six sites, including both hospital inpatients and outpatient clinic visitors. The device successfully produced an automated reading in the vast majority of patients (about 86% of inpatients and 95% of outpatients), and detected AF signals in about 1 in 5 patients overall. Importantly, it flagged 4 patients who had no previous AF diagnosis as possibly having the condition, and in one case that was confirmed the same day with a standard 12-lead ECG. The study also found meaningful practical challenges. Technical difficulties occurred in about 1 in 6 recordings, and were somewhat more common among hospitalized patients. The follow-up process broke down significantly — only 1 of the 4 newly suspected AF patients actually received the recommended confirmatory test on the same day. Additionally, very few patients (only about 6%) regularly used any telemedicine tools, suggesting that integrating mobile health technology into routine care may face adoption barriers among patients. This research suggests that mobile single-lead ECG devices can work in real-world clinical settings and may help catch undiagnosed atrial fibrillation, particularly in older patients. However, the findings also highlight that deploying these tools effectively requires more than just the technology itself — reliable follow-up protocols and strategies to improve patient and provider engagement with digital health tools are needed to translate screening into confirmed diagnoses and treatment.
Fenske R, Rossa D, Butter C, Muehlensiepen F, Nübel J, Meretz D, et al.. (2026). Feasibility of Mobile Single-Lead Electrocardiogram Screening for Atrial Fibrillation: Multicenter Cross-Sectional Study.. JMIR cardio. https://doi.org/10.2196/92799