PPG versus an insertable monitor after cryptogenic stroke

Objective

To ask whether PPG technology can yield the same results as an insertable cardiac monitor in patients after a cryptogenic stroke or transient ischaemic attack.

Approach

Patients at Ziekenhuis Oost-Limburg who had suffered a cryptogenic stroke or TIA received an insertable cardiac monitor and were also asked to use a blinded PPG-based FibriCheck app on a wearable. During the trial, 68,748 one-minute recordings were collected with FibriCheck.

Outcome

The ICM algorithm flagged AF in 10 patients and other arrhythmias in 19; a remote monitoring team confirmed AF in 1 and other arrhythmias in 5. The confirmed AF case was also registered by FibriCheck. PPG is non-invasive, less expensive and usable anywhere at any time, and the trial noted that even state-of-the-art insertable monitors yielded many false positives.