Response by Halcox and Wareham to Letter Regarding Article, “Assessment of Remote Heart Rhythm Sampling Using the AliveCor Heart Monitor to Screen for Atrial Fibrillation: The REHEARSE-AF Study”
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We are grateful for the interest shown by Koshy et al in our recent study, which showed that twice-weekly ECG monitoring with the AliveCor mobile device increased the diagnosis of atrial fibrillation (AF) almost 4-fold in >65-year-olds with CHADS-VASc scores of ≥2.1 They rightly highlight the potential practical implications of the low positive predictive value for AF diagnosis according to the AliveCor automated diagnostic algorithm (AliveCor version 2.2.0 [build 21]). We agree that this is probably the greatest technical challenge limiting routine adoption of such an approach, despite its diagnostic potential and acceptability within the target population.
The majority of false positives were indeed caused by ectopy, predominantly atrial …