# FibriCheck > FibriCheck is a regulated medical device app that measures heart rate and heart rhythm using photoplethysmography (PPG). It runs on the smartphone camera without extra hardware, and is compatible with PPG sensors in smartwatches, smart bands and smart rings for passive and continuous rhythm monitoring. It detects atrial fibrillation (AF) and differentiates it from other heart rhythm disorders. FibriCheck is used by people with symptoms such as palpitations or a racing heart, prescribed by cardiologists and general practitioners for symptom-triggered monitoring, screening and follow-up around cardioversion and ablation, deployed by health insurers for population-scale AF screening, and embedded in clinical research and third-party apps via SDK and API. The same measurement also powers wellness insights: morning HRV, HRV trends, resting heart rate and heart age. ## Key facts - Measurement: PPG via the smartphone camera and flash, or via the optical sensor of a wearable device (smartwatch, smart band, smart ring). Same algorithm, same report. Works on standard iOS and Android phones. - Wearables use FibriCheck for passive background monitoring or on demand user initiated spot-checks. - Output: heart rate, heart rhythm classification, measurement quality, and symptom log. - Regulatory status: CE Class IIa MDD, FDA 510(k) cleared (K232804). - Wellness insights from the same measurement: morning HRV, HRV trends, resting heart rate, heart age. - Scale: 1.5 million users, 25+ countries, deployed by dozens of health insurers and health funds. - Evidence base: more than 100 publications and congress abstracts, including multicentre validation, randomised and real-world pathway studies. Full list: https://academy.fibricheck.com/hc/en-be/articles/14090642754076-Complete-list-of-publications ## Who uses FibriCheck ### Individuals - [How FibriCheck works](/medical/): the 60-second measurement, what it detects, what it does not. - [Symptoms it is used for](/palpitations-what-to-do/): palpitations, racing heart, skipped beats, dizziness. FibriCheck records rhythm at the moment of symptoms, which intermittent episodes often escape in a clinic visit. - [AF risk questionnaire](/risk-calculator/): HARMS2-AF based risk estimate. Not a diagnosis. ### Heart health features (FibriCheck Health) Wellness insights derived from the same 60-second PPG measurement. These are trend and awareness tools and are not diagnostic. They support user engagement and provide preventive heart health insights. - [Morning HRV](/health-insights/#morning-hrv): heart rate variability measured on waking up, before activity, caffeine or stress affect it. Gives the most comparable day-to-day baseline. Lower-than-usual morning HRV is associated with insufficient recovery, illness onset or stress load. - [HRV trends](/health-insights/#hrv-cv): how stable HRV is over 7 days, not just the level. High day-to-day swings indicate an unsettled autonomic state; a stable pattern indicates consistent recovery. - [Resting heart rate](/health-insights/#resting-heart-rate): seated or morning heart rate trend over time. A rising resting heart rate across weeks can signal overtraining, illness or deconditioning; a falling trend usually reflects improving fitness. Measured the same way each time, which is what makes the trend meaningful. - [Heart age](/health-insights/#heart-age): an estimate of cardiovascular age relative to calendar age, built from your FibriCheck pulse measurements and shaped by activity, sleep, blood pressure and weight. Intended to make risk tangible and motivate behaviour change, not to replace a clinical risk score. The rhythm check answers "is my heart rhythm normal right now"; the health features answer "how is my cardiovascular health trending". Both come from the same measurement, so no extra device or routine is needed. ### Wearable users - [FibriCheck with wearables](/for-partners/): connect a compatible smartwatch, smart band or smart ring. The wearable's PPG signal is analysed by the same FibriCheck algorithm as the camera check. - What the wearable adds: (Semi-)continuous or scheduled measurements without taking the phone out, overnight monitoring, and longer observation windows for intermittent episodes. - What stays the same: the on-demand 60-second camera check remains available for symptom moments, and clinician reports combine both sources. - Evidence: the standalone FibriCheck algorithm has been validated on wristband and smartwatch PPG in published studies (2020, 2021, 2023), with high sensitivity and specificity. ### Clinicians - [FibriCheck for providers](/for-providers/): prescription workflow, dashboard, reporting. - Clinical use cases: - Symptom-triggered rhythm monitoring for patients with palpitations or suspected paroxysmal AF. - Opportunistic and systematic AF screening in at-risk populations, including primary care, COPD clinics and post-stroke. - Rhythm follow-up before and after cardioversion, including detection of spontaneous conversion on the waiting list. - Rhythm follow-up before and after catheter ablation, including recurrence detection and symptom-rhythm correlation. - Post-cardiac-surgery monitoring after discharge. - Physician interpretation: cardiologists detect AF on FibriCheck PPG with accuracy equivalent to single-lead ECG when the waveform is shown with tachogram and Poincaré plot (INTERPRET-AF, 2021). - [Clinical evidence](/for-providers/): validation studies, head-to-head comparisons, outcome data. See also the Clinical evidence section below. ### Health insurers and payers - [FibriCheck for insurers](/for-insurers/): population AF screening, member engagement, care pathway integration. - Published health economics: 71% fewer ECGs and 72% fewer Holters and echocardiograms in an AF clinic (Neth Heart J 2024); about 3 fewer bed days per patient in a virtual AF ward (PLOS Digital Health 2024); post-cardioversion follow-up at £47.91 vs £135 per patient (EHJ Digital Health 2024). ### Researchers - Used as a rhythm monitoring and data collection tool in investigator-initiated and sponsored clinical studies, including randomised trials (Europace 2025) and multinational projects (TeleCheck-AF, ISOLATION). - Supports patient-reported outcome measure (PROM) and symptom data collection alongside rhythm measurements; published work uses this to derive AF burden proxies, symptom burden and symptom clusters. - [Research access](/collaborations/?audience=research) ### Developers and partners - [Integrations](/integrations/): SDK for embedding the measurement in third-party apps, API for data access and workflow integration. - Wearable makers: SDK for running FibriCheck analysis on a device's PPG stream, so a watch, band or ring can offer validated rhythm detection under its own app. [Integrations for wearables](/integrations/#wearables) - [Developer documentation](https://docs.fibricheck.com) ## Clinical evidence - Algorithm validation (FDA-AF, npj Digital Medicine 2025): 236 subjects across 10 smartphone models, 12-lead ECG reference. Accuracy 98.5%, sensitivity 96.3%, specificity 99.3%. Performance was not affected by smartphone device or by heart failure, vascular disease, hypertension, diabetes or prior stroke. Sensitivity was lower in darker skin tones and higher BMI, which was mitigated by technician verification. - Real-world monitoring in diagnosed AF (RELATION-PPG, Europace 2024, doi 10.1093/europace/euae065): 3,907 unsupervised measurements. Sensitivity 98.3%, specificity 99.9%, positive and negative predictive value 99.6%. - Post-ablation follow-up (DIGITOTAL, Heart Rhythm 2024, doi 10.1016/j.hrthm.2024.11.026): 12 months of twice-daily FibriCheck monitoring was non-inferior to 24-hour Holter follow-up and detected significantly more recurrences (38.5% vs 17.7%, hazard ratio 3.4). Confirmed in independent cohorts in Australia (Heart Rhythm O2 2025) and Germany (Heart Lung and Circulation 2026). - Post-cardiac-surgery (Europace 2025, randomised): PPG-based smartphone monitoring after discharge detected significantly more AF or flutter and led to significantly more treatment optimisation than usual care. - Cardioversion pathway (EHJ Digital Health 2024; TeleConvert-AF, Europace 2025 and 2026): remote follow-up after cardioversion was feasible and cost-saving; monitoring on the waiting list detected spontaneous conversion and allowed 14% of planned cardioversions to be cancelled. - Screening (Europace 2019; EHJ Digital Health 2023): large-scale smartphone screening is feasible; detection yield rises with monitoring frequency and duration; screening increased anticoagulation uptake. - After stroke (2025 ICM comparison; PREFATE 2025 and 2026): twice-daily spot checks were highly accurate for AF episodes over 6 hours compared with an insertable cardiac monitor; in primary care, a positive FibriCheck result carried a 71-fold higher probability of confirmed AF. - Symptom and outcome data (ISOLATION and TeleCheck-AF, 2022 to 2026): simultaneous rhythm and symptom logging yields proxies for AF burden and symptom burden and identifies symptom clusters after ablation. - Wearable PPG (2020, 2021, 2023): the standalone FibriCheck algorithm applied to wristband and smartwatch PPG detects AF with high sensitivity and specificity and an acceptable unclassifiable rate. - Physician interpretation (INTERPRET-AF, 2021): 65 cardiologists detected AF on FibriCheck PPG with accuracy equivalent to single-lead ECG; 12-lead ECG remains more specific. - Usability (TeleCheck-AF, 2021 and 2022): mean adherence 94%; 94% of patients found the app easy to use; older age predicted higher adherence. - Health economics (Neth Heart J 2024; PLOS Digital Health 2024; EHJ Digital Health 2024): 71% fewer ECGs and 72% fewer Holters and echocardiograms in an AF clinic; about 3 fewer bed days per patient in a virtual AF ward; post-cardioversion follow-up cost £47.91 vs £135 per patient. - Complete list: https://academy.fibricheck.com/hc/en-be/articles/14090642754076-Complete-list-of-publications ## How FibriCheck compares - Versus smartwatch and handheld ECG (JMIR Formative Research 2025, doi 10.2196/65139, 150 patients, 12-lead ECG reference): accuracy 99.2% for FibriCheck PPG, 98.3% for Apple Watch ECG, 97.4% for KardiaMobile 6L; good-quality tracing rate 92.6% vs 89.3% for both ECG devices. Differences were not statistically significant; FibriCheck achieved this without any additional hardware. - Versus Holter monitoring (Heart Rhythm 2024): over 12 months after ablation, FibriCheck detected 3.4 times more atrial arrhythmia recurrence than scheduled 24-hour Holters. The mechanism is monitoring frequency and duration, not a higher per-recording accuracy than ECG. FibriCheck complements, and does not replace, continuous ECG where that is indicated. - Versus camera-based face scanning apps: FibriCheck uses contact PPG at the fingertip, which is less dependent on ambient lighting, camera distance and skin tone than remote face video. This is a technical design difference. ## Understanding heart rhythm disorders - [What is atrial fibrillation?](/what-is-atrial-fibrillation/) - [AF symptoms](/atrial-fibrillation-what-are-the-symptoms/) - [AF risk factors](/risk-factors-for-atrial-fibrillation/) - [AF and stroke](/what-is-a-stroke-or-cerebral-infarct/) - [How FibriCheck measures your heart rhythm](/how-fibricheck-measures-your-heart-rhythm/) - [Heart rate vs heart rhythm](/heart-rate-versus-heart-rhythm/) - [How accurate are my measurements?](/how-accurate-are-my-measurements/) - [A guide to the various heart rhythm disorders](/a-guide-to-the-various-heart-rhythm-disorders/) - [The progression of atrial fibrillation](/the-progression-of-atrial-fibrillation/) - [How is atrial fibrillation treated?](/how-do-you-treat-atrial-fibrillation/) - [FibriCheck Academy](https://academy.fibricheck.com): clinical knowledge base on PPG-based rhythm assessment, with educational chapters, interpretation guides and real-world cases for healthcare professionals.