"AON-Ottawa-AF": The Always ON Ottawa Atrial Fibrillation project. A programme to develop the world’s first “always-on” miniaturized personal arrhythmia detector.
Cardiovascular and Stroke Care
UOHIAMO, University of Ottawa Heart Institute, Ottawa Ontario
An “always on” arrhythmia detection device offers the potential to transform healthcare delivery in the following ways:(i) to reliably detect the development of Atrial Fibrillation (AF) in longitudinal studies of the general (healthy) population (ii) to accurately define the natural history of AF, stroke and systemic embolism (iii) identify AF sub-types for prognostic purposes and (iv) calculate arrhythmia burden in affected individuals.
This would facilitate, for the first time, the design and testing of primary prevention strategies and the assessment of efficacy of secondary interventions in AF. This technology will be marketed direct to the general population and thus not limited to “patients”. It is hoped that this inexpensive technology will be easily adopted by citizens and their healthcare providers throughout Canada and the rest of the world. Notwithstanding the economic benefits from the creation of such technology, “AON Ottawa-AF” has the potential to facilitate outcomes research not only in AF and stroke but also into early detection of ventricular arrhythmia and prevention of sudden cardiac death.
Atrial Fibrillation (AF), the most common sustained cardiac arrhythmia, is currently estimated to effect > 350,000 Canadians. The lifetime risk of developing AF in those aged ≥ 40 years is currently 25% and is projected to rise. A progressive disorder, AF episodes are initially brief and often asymptomatic. However, whether symptomatic or not, AF promotes clot formation within the heart which is the most common single cause of thrombotic stroke. Most patients with AF are not diagnosed early. Sadly, almost 10000 Canadians with undiagnosed AF suffer the most deadly complication of AF, a stroke, every year. Recently it has become clear that AF can be predicted and rapidly diagnosed by long term cardiac monitoring, but current monitors are intrusive and expensive. However, if those who do develop AF are rapidly identified and appropriately treated with oral anticoagulation (OAC), the subsequent risk of stroke is reduced by > 60%. Predictions suggest that if only half of eligible patients commence OAC within one year of AF onset almost a third of all strokes could be prevented, with enormous benefits to all. We aim to develop, build and test a miniature, inexpensive, unobtrusive, “always-on”, remotely monitored cardiac monitor to detect AF.