Patient Identification

ED AF <48h Protocol

Order Sets: ED AF <48h Protocol

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ED AF >48h/Unknown Duration Protocol

Order Sets: ED AF >48h/Unknown Duration Protocol

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Clinical Validation of 5 Direct-to-Consumer Wearable Smart Devices to Detect Atrial Fibrillation – BASEL Wearable Study

Journal Articles: BACKGROUND Multiple smart devices capable to detect atrial fibrillation (AF) are presently available. Sensitivity and specificity for the detection of AF may differ between available smart devices, and this has not yet been adequately investigated. OBJECTIVES The aim was to assess the accuracy of 5 smart devices in identifying AF compared with a physician interpreted 12-lead electrocardiogram as the reference standard in a real-world cohort of patients. METHODS We consecutively enrolled patients presenting to a cardiology service at a tertiary referral center in a prospective, diagnostic study. RESULTS We prospectively analyzed 201 patients (31% women, median age 66.7 years). AF was present in 62 (31%) patients. Sensitivity and specificity for the detection of AF were comparable between devices: 85% and 75% for the Apple Watch 6, 85% and 75% for the Samsung Galaxy Watch 3, 58% and 75% for the Withings Scanwatch, 66% and 79% for the Fitbit Sense, and 79% and 69% for the AliveCor KardiaMobile, respectively. The rate of inconclusive tracings (the algorithm was unable to determine the heart rhythm) was 18%, 17%, 24%, 21%, and 26% for the Apple Watch 6, Samsung Galaxy Watch 3, Withings Scan Watch, Fitbit Sense, and AliveCor KardiaMobile (P < 0.01 for pairwise comparison), respectively. By manual review of inconclusive tracings, the rhythm could be determined in 955 (99%) of 969 single-lead electrocardiograms. Regarding patient acceptance, the Apple Watch was ranked first (39% of participants). CONCLUSIONS In this clinical validation of 5 direct-to-consumer smart devices, we found differences in the amount of inconclusive tracings diminishing sensitivity and specificity of the smart devices. In a clinical setting, manual review of tracings is required in about one-fourth of cases.

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Digestive Health Center Endoscopy Atrial Fibrillation Algorithm

Care Pathways/CDS: Care pathway for AFib patients presenting for an endoscopic procedure. Includes steps to follow, decision support tool, and link to the full guideline.

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Suspected AF Pathway

Care Pathways/CDS: Clinical Pathway for Suspected AF

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SOP Deep Analgesic Sedation in the EPU Laboratory

Education – Clinical: Workflow for deep analgesic sedation in the EPU laboratory. Includes medications, monitoring, and ACT control.

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SOP Atrial Fibrillation Therapy

Care Pathways/CDS: SOP for therapy options when treating AFib. Includes flow chart, decision trees, chart for AAD dosage, and risk factors/comorbidities.

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Suspected Atrial Fibrillation

Care Pathways/CDS: Clinical pathway for suspected atrial fibrillation.

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Confirmed AF Management Pathway

Care Pathways/CDS: Care pathway for management of confirmed AFib in patients. Includes information about underlying causes, treatment options, reducing stroke risk, and more.

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Oral Anticoagulation in Patients With Nonvalvular Atrial Fibrillation and a CHA2DS2-VASc Score of 1

Guidelines/Clinical Documents: Guidelines document outlining best practices for oral anticoagulation in patients with nonvalvular AFib and a CHA2DS2-VASc Score of 1.

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