LAUSR

Diagnosing atrial fibrillation (AF) involves detection of the typical AF rhythm pattern using an electrocardiogram (ECG). Opportunistic screening for untreated AF is recommended in people aged >65 years by pulse taking or ECG rhythm strip [1]. Recurrent or extended ECGmonitoring can improve detection of AF, but this is not always practical given the time inconvenience and associated costs. Photoplethysmography (PPG)-based smart devices may provide an opportunity for large-scale screening of AF by maximizing convenience and minimizing costs and time. An overview of the current available evidence regarding the accuracy and feasibility of using PPG-based smart devices for AF detection will be described in this editorial, although it is not a comprehensive review. AF is the most common-sustained arrhythmia and is a major cause of stroke and cardiovascular morbidity and mortality globally, but people with AF are often asymptomatic and remain undiagnosed. Oral anticoagulants (OACs) can prevent strokes related to AF [2]. Furthermore, an integrated approach to AF management using the AF Better Care (ABC) pathway can be applied to improve outcomes for people with AF by: A) Avoiding stroke with Anticoagulants; B) Better symptom management with a patient-centered approach to rhythmor rate-control; and C) Cardiovascular or co-morbidity management [3]. Data to support the use of OACs in preventing stroke in patients with asymptomatic AF are lacking but use of OACs is recommended in all AF patients unless they are at low-risk for stroke based on the CHA2DS2VASc score [1]. AF burden ≥5.5 h on any day in the most recent 30 days is associatedwith an approximate doubling of the risk of a thromboembolic event comparedwith no AF burden [4]. Early detection of AF is critical to monitor patients with AF and implement patient-centered interventions to reduce risk of stroke and improve outcomes; therefore, innovative approaches to improve screening and detection of AF are of high interest.