Photoplethysmography for the management of atrial fibrillation
Topic Status Complete
Photoplethysmography for the management of atrial fibrillation
Outcome of the appraisal
Smartphone photoplethysmography (PPG) shows promise for the detection and monitoring of atrial fibrillation in adults with known or suspected atrial fibrillation, but the evidence is insufficient to support routine adoption.
The available evidence indicates that PPG applications have good diagnostic accuracy, and their use could potentially lead to a reduction in resource use and a faster diagnosis for some patients.
The evidence to support longer-term effectiveness and long-term resource use savings is limited and there is not enough evidence to support the cost effectiveness of smartphone PPG.
The Appraisal Panel strongly encourages further research generation in this area.
Why was this topic appraised?
More than 1.6 million people have been diagnosed with atrial fibrillation (AF) in the UK and more than 80,000 people have been diagnosed in Wales. In Wales, atrial fibrillation is a contributing factor to one in five strokes and there are approximately 15,000 people aged 65 years or older with undiagnosed AF. Atrial fibrillation has a broad impact on health services across both primary and secondary care.
The development of smartphone-based screening and monitoring devices has the potential to increase screening coverage, improve clinical detection, and facilitate the monitoring of AF without the need for external and additional hardware.
This topic was proposed by a device manufacturer (FibriCheck).
Plain language summary
Atrial fibrillation (AF) is a condition that causes an irregular and fast heartbeat. People with AF can experience heart palpitations, dizziness, and shortness of breath. It’s not clear what causes atrial fibrillation, but it’s common in people with other heart conditions such as stroke and heart failure. If the health of the heart deteriorates, it can lead to hospitalisation.
Treatments for atrial fibrillation include medicines to control the heartbeat and thin the blood. However, it can be difficult to diagnose as the heart needs to be monitored for irregular and fast heartbeats. The development of smartphone-based screening is proposed to help make this monitoring easier.
Smartphone based apps, such as the FibriCheck App, uses a technology called photoplethysmography (PPG) to identify AF. The apps use cameras on a smartphone to detect small changes in light absorption from fingertips to measure heart beats. In the case of the FibriCheck app, this then uses Artificial Intelligence (AI) to distinguish AF rhythms from normal heart rhythms.
Health Technology Wales looked for evidence on the effectiveness of PPG apps, including FibriCheck, for the management atrial fibrillation. PPG shows promise for the detection and monitoring of atrial fibrillation in adults with known or suspected atrial fibrillation, but the evidence is insufficient to support routine adoption.
Topic Exploration Report
TER552 06.2024
Evidence Appraisal Report
EAR067 05.2025
Guidance
GUI067 05.2025
Health Technology Wales Partners
