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AF Screening with Wearables — EECC MCQ

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EasyArrhythmia & ElectrophysiologyAF Screening with WearablesEECC

A 30-year-old woman with no known cardiac disease wears a smartwatch that detects an irregular rhythm and notifies her of possible AF. She is asymptomatic. A 12-lead ECG during the episode shows AF. How should this be managed according to the 2024 ESC AF Guidelines?

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Correct answer: C — Confirm the diagnosis with a 12-lead ECG or single-lead ECG ≥30 seconds; if AF confirmed, assess with CHA₂DS₂-VA score and proceed with standard AF management

The 2024 ESC AF Guidelines acknowledge the role of consumer wearable devices (smartwatches, photoplethysmography-based sensors) in AF screening but emphasise that any positive detection must be confirmed by a validated single-lead ECG tracing ≥30 seconds or a 12-lead ECG before a diagnosis of AF is made and treatment initiated. In this case, the 12-lead ECG has already confirmed AF. Standard AF management should follow: symptom assessment, CHA₂DS₂-VA scoring for stroke risk, rate/rhythm control consideration, and comorbidity management per the AF-CARE pathway. The Apple Heart Study and Huawei Heart Study demonstrated that wearable-detected AF has clinical significance.

Reference: ESC (2024): Guidelines for the Management of Atrial Fibrillation