Screening for atrial fibrillation in the over-75s with handheld ECG devices

Participants will acquire a single-lead electrocardiogram (ECG) trace by placing minimum one finger of each hand on each small touchpad (3cm x 3cm) of the device for 30 seconds once daily on weekdays (12 months for intervention group and 6 months for waitlist group). The device is connected to their mobile phone wirelessly and an ECG trace will appear on the mobile phone confirming that the participant has recorded their ECG. Participants confirm their identity and ECG will be transmitted to a central monitoring system automatically. Participants will receive printed instructions on “how to download the Kardia app into their mobile phone” and “how to set up an account to use the app” when they receive the handheld ECG device. We will also send participants a mobile text message with a weblink that will take them to a training video produced by the device manufacturer (AliveCor Kardia). Participants can click on the weblink to watch the short video. In addition, study personnel will call each participant to support and help the participant overcome any technical difficulties and test run the device to make sure all participants can acquire an ECG and answer any questions participants may have. The above training and interaction will take approximately 30 – 60 minutes per participant. The intervention program will commence upon successful transmission of first ECG from each participant. Participants will receive daily notification to do their ECG. If no ECG is received for three consecutive days, our central review process will identify this, and a study personnel will then contact the participants by phone, text message or email. At 6-month follow up or upon diagnosis of atrial fibrillation (whichever occurs first), participants will be invited to participate in a survey and one-to-one interview to assess their satisfaction and feedback about their experience in the program.