Screening for Atrial Fibrillation With Self Pulse Monitoring

The goal of this clinical trial is to determine the efficacy of self-pulse monitoring in detecting atrial fibrillation (AF) in adult patients at increased risk of stroke. The main questions it aims to answer are: Is self-screening an effective modality for diagnosis of AF? Are there clinical differences and outcomes for patients who self-screen? Eligible participants will be randomized to either the intervention group or control group. The control group will continue with usual standard of care. Participants randomized to the intervention group will be asked to: View an online educational video to teach them the appropriate way to manually check their pulse for irregularities. Manually check their pulse for 30 seconds twice daily for 14 days. Patients who screen positive for irregularities will be sent a 14-day wearable cardiac monitor to assess for underlying arrhythmias. Researchers will compare the intervention group to the control group to see if there are clinical differences and outcomes.

Participants will be recruited for this study using MyChart recruiting. Participants meeting inclusion criteria will be invited to participate and can respond "interested" or "decline." Participants who respond interested will complete a brief survey to confirm eligibility prior to consenting. One the participant consents, they will be randomized to the self-pulse check/intervention group or control group.

Participants view an educational video instructing them on how to manually check their pulse for irregularities. Participants will be instructed to check their pulse for 30 seconds twice daily for 2 weeks.

Participants assigned to the intervention group are instructed on how to manually check their pulse to detect irregularities. Those who screen positive for irregularities will be sent a 14-day wearable cardiac monitor to confirm diagnosis of AF. Diagnosis of AF can also be confirmed by electrocardiogram (ECG) at an outpatient clinic visit.

Participant data will be collected from the electronic health record one year after randomization to assess how many participants from each arm are subsequently diagnosed with AF.

Participant data will be collected from the electronic health record one year after randomization to assess how many participants from each arm are subsequently diagnosed with AF. For participants with a diagnosis of AF, the time in days from randomization to diagnosis will be calculated.

Participant data will be collected from the electronic health record one year after randomization to assess how many participants are prescribed anticoagulation medications.

Participant data will be collected from the electronic health record one year after randomization to assess how many participants have a diagnosis of stroke, TIA, or systemic embolism.

Inclusion Criteria: Age 18 or greater No known history of atrial fibrillation or atrial flutter Access to MyChart CHA2DS2-VASc sore (described below) >/= 2 (male) or >/=3 (female) based on the following criteria: Two points: Age ≥75, prior stroke One point: Age ≥65-74, congestive heart failure, hypertension, diabetes, vascular disease Exclusion Criteria: Prior diagnosis of atrial fibrillation or atrial flutter Unable to consent Currently incarcerated Self-pay/uninsured Taking anticoagulation for other medical conditions than atrial fibrillation or atrial flutter

Deidentified individual data that supports the results will be shared beginning 12 to 36 months following publication provided the investigator who proposes to use the data has approval from an Institutional Review Board (IRB), Independent Ethics Committee (IEC), or Research Ethics Board (REB), as applicable, and executes a data use/sharing agreement with UNC.

Deidentified individual data that supports the results will be shared beginning 12 to 36 months following publication.

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