Atrial fibrillation (AF) causes high risk of stroke ^[1]. Approximately 40% of AF patients  have no symptoms ^[2] so that many of them are diagnosed by coincidence when hospitalized for other reasons ^[3], including stroke ^{[4, 5]}.

Who is affected?
AF is the most common sustained cardiac arrhythmia occurring in 5% of the population of 65 years and older and in 14% older than 85 years. AF leads to a 5-fold higher risk of stroke and is responsible for 20% of all strokes. Many people have no symptoms from AF and therefore remain undiagnosed. Early detection of AF followed by adequate treatment can reduce the risk of a stroke by 68%. ^[6-8] 

What is Atrial Fibrillation (AF)?
In the case of AF, the heart chambers beat chaotically and irregularly. This can cause blood to accumulate in the atria of the heart, clump together, and form blood clots. These blood clots can then migrate through the bloodstream to the brain, where they block the blood vessels and this causes a stroke. The dangerous part of AF is, that about 70% of the AF episodes are asymptomatic and remain undiagnosed. In addition, in the beginning, AF generally appears only irregularly and can, therefore, be overlooked even during sporadic doctor's visits. Following risk factors can additionally increase the risk of having AF: age, hypertension, diabetes, obesity, cardiovascular diseases, stress, smoking and alcohol.

How Microlife’s patented AFIBsens technology works
Microlife blood pressure monitors with implemented AFIBsens™ technology, allow patients to be screened for AF during blood pressure measurements at home, using a sophisticated algorithm.  If AF is detected during blood pressure measurements, the AFIB symbol is displayed. Microlife AFIBsens™ does not make a diagnosis, but provides important information for your doctor, who can refer you for a 12-lead ECG to confirm the presence of AF.

A systematic review of all clinical evidence to the Microlife AFIBsens™ detector ^[9] showed that the highest sensitivity value (97%) is obtained when separate, sequential heart rhythm analyses were performed, with two or three readings being AF positive. The highest specificity value (97%) is obtained when all three heart rhythm analyses being positive for AF. For this reason the Microlife blood pressure monitors with AFIBsens™ technology automatically carries out three heart rhythm analysis when screening for atrial fibrillation.

Microlife AFIBsens™ technology is implemented on Microlife blood pressure monitors in conjunction with the Microlife Average Mode (MAM) technology. Three analyses of heart rhythm are conducted in conjunction with the triplicate blood pressure measurements of MAM, and the AF screening result is provided together with the average blood pressure reading of MAM.

AFIBsens™ Advanced is the latest evolution of Microlife AFIBsens™ technology, to make AF screening at home more faster and more user friendly. Microlife blood pressure monitors with AFIBsens™ Advanced feature conducts three heart rhythm analyses for AF detection, whether using MAM’s triplicate measurement or the normal single measurement for blood pressure reading, to ensure the benefit of AF screening is always available at home.

Microlife AFIBsens: tested and clinically proven for detecting atrial fibrillation
Microlife AFIBsens detects AF with high accuracy (sensitivity 98%, specificity 92%) as demonstrated in multiple comparative studies with ECG. It can be used as a reliable screening test for early diagnosis.

All studies were compared against 12-lead ECG unless otherwise indicated; n.s. indicates not specified; *compared against electrocardiographic diagram

Irregular heartbeat feature – what is the difference with AFIBsens technology?

“The main purpose of the IHB detector, therefore, is not to diagnose arrhythmias but rather to serve as a warning message indicating that the BP reading may not be accurate because of the presence of arrhythmia ^{[9, 19]}“

The majority of the available blood pressure devices allow blood pressure measurements to be applied simultaneously to irregular heartbeats and arrhythmias. However, this does not distinguish between the different types of arrhythmias. If the IHB / IHD symbol appears in the display, non-hazardous arrhythmias such as sinus arrhythmia, premature atrial contractions (PAC) or bradycardia are also included. This can lead to patient insecurity.

Microlife AFIBsens technology is medically proven technology for blood pressure devices that detects dangerous atrial fibrillation. The high degree of accuracy has been proven several times in clinical trials and has been recommended by international specialists and physicians.

Microlife AFIBsens in primary care

#1 Atrial fibrillation detection recommended by doctors ^[20]

The AF detection system has convincingly proven its accuracy and showed that it leads to increased detection of new patients with AF when used in general clinical practice.

Recommended by NICE (UK)
The National Institute for Health and Care Excellence (NICE) officially recommends using the WatchBP Home A during routine blood pressure measurement for all general practitioners in the United Kingdom. ^[20] 

• “The available evidence suggests that the device reliably detects atrial fibrillation and may increase the rate of detection when used in primary care.”
• “WatchBP Home A should be considered for use in people with suspected hypertension and those being screened or monitored for hypertension, in primary care.”
• Prevention of 2,000 strokes per year in the UK (81 per 100,000 patients screened aged 65 - 75 years and 182 per 100,000 patients aged 75 years and older).
• Healthcare cost savings of € 31 million a year

Oxford trial 2013
The University of Oxford in the UK, known as one of the best medical universities in the world, has performed a randomized clinical trial among 1,000 GP patients to reveal the best method for AF screening in primary care. This study showed that using the Microlife WatchBP Home A is the best method and is recommended for AF screening in primary care practice and for patients at home.

“Conclusions: WatchBP performs better as a triage test for identifying AF in primary care than the single-lead ECG monitors as it does not require expertise for interpretation and its diagnostic performance is comparable to single-lead ECG analysis by cardiologists. It could be used opportunistically to screen elderly patients for undiagnosed AF at regular intervals and/or during BP measurement. ^[14]” 

1.   Nichols M TN, Luengo-Fernandez R, Leal J, Gray A, Scarborough P, Rayner M European Cardiovascular Disease Statistics 2012. European Heart Network, Brussels, European Society of Cardiology, Sophia Antipolis 2012.
2.   Boriani G, Laroche C, Diemberger I, Fantecchi E, Popescu MI, Rasmussen LH et al.: Asymptomatic atrial fibrillation: clinical correlates, management, and outcomes in the EORP-AF Pilot General Registry. Am J Med 2015; 128:509-518 e502.
3.   Zoni-Berisso M, Lercari F, Carazza T, Domenicucci S: Epidemiology of atrial fibrillation: European perspective. Clin Epidemiol 2014; 6:213-220.
4.   Sanna T, Diener HC, Passman RS, Di Lazzaro V, Bernstein RA, Morillo CA et al.: Cryptogenic stroke and underlying atrial fibrillation. N Engl J Med 2014; 370:2478-2486.
5.   Gladstone DJ, Spring M, Dorian P, Panzov V, Thorpe KE, Hall J et al.: Atrial fibrillation in patients with cryptogenic stroke. N Engl J Med 2014; 370:2467-2477.
6.   Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH et al.: 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation--developed with the special contribution of the European Heart Rhythm Association. Europace 2012; 14:1385-1413.
7.   Hart RG, Benavente O, McBride R, Pearce LA: Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: a meta-analysis. Ann Intern Med 1999; 131:492-501.
8.   Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD et al.: Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014; 383:955-962.
9.   Verberk WJ, Omboni S, Kollias A, Stergiou GS: Screening for atrial fibrillation with automated blood pressure measurement: Research evidence and practice recommendations. Int J Cardiol 2016; 203:465-473.
10.   Wiesel J, Wiesel D, Suri R, Messineo FC: The use of a modified sphygmomanometer to detect atrial fibrillation in outpatients. Pacing Clin Electrophysiol 2004; 27:639-643.
11.   Stergiou GS, Karpettas N, Protogerou A, Nasothimiou EG, Kyriakidis M: Diagnostic accuracy of a home blood pressure monitor to detect atrial fibrillation. J Hum Hypertens 2009; 23:654-658.
12.   Wiesel J, Fitzig L, Herschman Y, Messineo FC: Detection of atrial fibrillation using a modified microlife blood pressure monitor. Am J Hypertens 2009; 22:848-852.
13.   Wiesel J, Abraham S, Messineo FC: Screening for asymptomatic atrial fibrillation while monitoring the blood pressure at home: trial of regular versus irregular pulse for prevention of stroke (TRIPPS 2.0). Am J Cardiol 2013; 111:1598-1601.
14.   Kearley K, Selwood M, Van den Bruel A, Thompson M, Mant D, Hobbs FR et al.: Triage tests for identifying atrial fibrillation in primary care: a diagnostic accuracy study comparing single-lead ECG and modified BP monitors. BMJ Open 2014; 4:e004565.
15.   Wiesel J, Arbesfeld B, Schechter D: Comparison of the Microlife blood pressure monitor with the Omron blood pressure monitor for detecting atrial fibrillation. Am J Cardiol 2014; 114:1046-1048.
16.   Gandolfo C, Balestrino M, Bruno C, Finocchi C, Reale N: Validation of a simple method for atrial fibrillation screening in patients with stroke. Neurol Sci 2015; 36:1675-1678.
17.   Chan PH, Wong CK, Pun L, Wong YF, Wong MM, Chu DW et al.: Head-to-Head Comparison of the AliveCor Heart Monitor and Microlife WatchBP Office AFIB for Atrial Fibrillation Screening in a Primary Care Setting. Circulation 2017; 135:110-112.
18.   Chan PH, Wong CK, Pun L, Wong YF, Wong MM, Chu DW et al.: Diagnostic performance of an automatic blood pressure measurement device, Microlife WatchBP Home A, for atrial fibrillation screening in a real-world primary care setting. BMJ Open 2017; 7:e013685.
19.   Alpert BS, Quinn D, Gallick D: Oscillometric blood pressure: a review for clinicians. J Am Soc Hypertens 2014; 8:930-938.
20.   NICE: WatchBP Home A for opportunistically detecting atrial fibrillation during diagnosis and monitoring of hypertension http://guidance.nice.org.uk/MTG13. 2013; Assessed 18 Aug. 2015.

* Microlife home blood pressure monitors with Microlife AFIBsens technology are not available in USA