Intelligent Monitoring to Predict Atrial Fibrillation

NCT ID: NCT06600620

Last Updated: 2025-09-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

SUSPENDED

Total Enrollment

1200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-09-23

Study Completion Date

2028-08-01

Brief Summary

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Atrial Fibrillation (AF) is the commonest arrhythmia worldwide, affects 5% of people over the age of 65 and increases the risk of stroke and heart failure. The investigators aim to detect clinical and subclinical episodes of atrial fibrillation lasting \>30 seconds to develop risk prediction models to identify patients at high risk for ischaemic stroke.

Detailed Description

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Atrial Fibrillation (AF) is the commonest arrhythmia worldwide, affects 5% of people over the age of 65 and increases the risk of stroke and heart failure. Among acutely unwell patients; arrhythmias and myocardial injury are common and associated with increased mortality, morbidity, and healthcare costs. Cardiovascular comorbidities in these high-risk patients include hypertension (47%), dyslipidaemia (29%) and ischaemic heart disease (11%).

The investigators aim to detect clinical and subclinical episodes of atrial fibrillation lasting 30 seconds to develop risk prediction models to identify patients at high risk for ischaemic stroke. Data will serve to develop and validate bedside clinical decision support tools and digital twins. Patients who develop episodes of AF as part of acute illness, will suffer further episodes of AF within one year in over 20% of cases with 27% progressing to paroxysmal/permanent AF. The true incidence of AF is unknown in acutely unwell patients as a significant percentage of AF episodes remain undetected with conventional intermittent monitoring. Patients experiencing short self-terminating episodes of AF carry a 5-fold risk of developing continuous AF and double the risk of stroke and thromboembolic events. Patients suffering episodes of AF often remain asymptomatic but are at increased risk of heart failure and death at one year. Compared to routine intermittent manual measurement of vital signs, wireless continuous vital sign monitoring systems (wCVSM) detect deviations instantaneously with the option of alerting clinical staff in real time via mobile phone applications. Accurate categorization of alerts into false and true events is essential for developing intelligent software that can be embedded into monitoring systems. Continuous ECG and vital signs monitoring can detect AF episodes more reliable, trigger timely investigations and support longer term treatment plans.

Changes in patient pathways and introduction of novel devices to alert healthcare staff on the potential of clinical events require buy-in from all stakeholders. It is therefore essential to evaluate user acceptance and to determine perceptions of users before rolling out a novel patient pathways or implementation of a new device within an organization. The investigators therefore wish to explore users\' views of the device, wearing the device and potential areas for improvement using questionnaires for patients and health care staff and by conducting semi-structured interviews with healthcare staff.

Primary objective To determine the true cardiovascular event rate (defined as at least one of the following criteria: episodes of AF, New Regional Wall Motion Abnormalities, raised cardiac biomarkers hs-troponin T and NT-pro-BNP) versus false cardiovascular events detected by continuous wireless remote monitoring.

Secondary objective To determine patient acceptability and usability for health care professionals of a novel remote monitoring device with automated alert function.

Conditions

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Atrial Fibrillation New Onset Postoperative Cardiovascular Complications Atrial Fibrillation

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients admitted or referred to Critical Care (NOTE-AF ICU)

Patients admitted or referred to Critical Care

Monitoring patients heart rythms with a wireless patch device

Intervention Type DEVICE

The investigators will collect data in patients at high risk of atrial fibrillation (AF) without a known history of AF to determine clinical predicators of AF. This data will be used to generate virtual digital twins to to predict clinical and subclinical episodes of AF

Patients admitted to hospital with acute heart failure (NOTE-AF HF)

Patients admitted to hospital with acute heart failure

Monitoring patients heart rythms with a wireless patch device

Intervention Type DEVICE

The investigators will collect data in patients at high risk of atrial fibrillation (AF) without a known history of AF to determine clinical predicators of AF. This data will be used to generate virtual digital twins to to predict clinical and subclinical episodes of AF

Patients admitted to Emergency Services with sepsis or infection (NOTE-AF Sepsis)

Patients admitted to Emergency Services with sepsis or infection

Monitoring patients heart rythms with a wireless patch device

Intervention Type DEVICE

The investigators will collect data in patients at high risk of atrial fibrillation (AF) without a known history of AF to determine clinical predicators of AF. This data will be used to generate virtual digital twins to to predict clinical and subclinical episodes of AF

Patients post upper gastrointestinal surgery (NOTE-AF PULSE-GI)

Patients post upper gastrointestinal surgery

Monitoring patients heart rythms with a wireless patch device

Intervention Type DEVICE

The investigators will collect data in patients at high risk of atrial fibrillation (AF) without a known history of AF to determine clinical predicators of AF. This data will be used to generate virtual digital twins to to predict clinical and subclinical episodes of AF

Patients post vascular interventions (NOTE-AF Vasc)

Patients post vascular interventions

Monitoring patients heart rythms with a wireless patch device

Intervention Type DEVICE

The investigators will collect data in patients at high risk of atrial fibrillation (AF) without a known history of AF to determine clinical predicators of AF. This data will be used to generate virtual digital twins to to predict clinical and subclinical episodes of AF

Patients with acute respiratory failure (NOTE-AF Resp)

Patients with acute respiratory failure

Monitoring patients heart rythms with a wireless patch device

Intervention Type DEVICE

The investigators will collect data in patients at high risk of atrial fibrillation (AF) without a known history of AF to determine clinical predicators of AF. This data will be used to generate virtual digital twins to to predict clinical and subclinical episodes of AF

Patients admitted after acute stroke (NOTE-AF stroke)

Patients admitted after acute stroke

Monitoring patients heart rythms with a wireless patch device

Intervention Type DEVICE

The investigators will collect data in patients at high risk of atrial fibrillation (AF) without a known history of AF to determine clinical predicators of AF. This data will be used to generate virtual digital twins to to predict clinical and subclinical episodes of AF

Interventions

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Monitoring patients heart rythms with a wireless patch device

The investigators will collect data in patients at high risk of atrial fibrillation (AF) without a known history of AF to determine clinical predicators of AF. This data will be used to generate virtual digital twins to to predict clinical and subclinical episodes of AF

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Adult patients ≥50 years
* Estimated risk of developing new episodes of AF greater than 5%
* Sinus rhythm at presentation
* One of the following acute conditions:

* Patients admitted or referred to Critical Care (NOTE-AF ICU)
* Patients admitted to hospital with acute heart failure (NOTE-AF HF)
* Patients admitted to Emergency Services with sepsis or infection (NOTE-AF Sepsis)
* Patients post upper gastrointestinal surgery (NOTE-AF PULSE-GI)
* Patients post vascular interventions (NOTE-AF Vasc)
* Patients with acute respiratory failure (NOTE-AF Resp)
* Patients admitted after acute stroke (NOTE-AF stroke)

Exclusion Criteria

* Atrial fibrillation or atrial flutter at the time of screening
* Patients in atrial fibrillation or atrial flutter at time of preoperative assessment or admission to hospital
* Paced cardiac rhythm
* Inability to obtain consent
* Allergy to plaster or silicone
* Expected hospital stay less than 48 hours
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Copenhagen

OTHER

Sponsor Role collaborator

Isansys Lifecare LTD

UNKNOWN

Sponsor Role collaborator

University of Liverpool

OTHER

Sponsor Role collaborator

Liverpool John Moores University

OTHER

Sponsor Role collaborator

Liverpool University Hospitals NHS Foundation Trust

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Liverpool university foundation trust

Liverpool, , United Kingdom

Site Status

Liverpool University hospital Foundation trust

Liverpool, , United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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JRO-0126

Identifier Type: -

Identifier Source: org_study_id

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