Because of the frequent asymptomatic presentation of atrial fibrillation (AF), stroke is too often its first manifestation.¹ For effective stroke prevention, timely diagnosis of AF is crucial. Mobile devices are becoming ubiquitous, providing significant possibilities for screening applications. In mechanocardiography, mechanical cardiac activity is recorded with accelerometers and gyroscopes, standard components of modern smartphones.² In our previous proof-of-concept study, smartphone mechanocardiography demonstrated 94% sensitivity and 100% specificity for detecting AF among 39 subjects.² Here, we validate smartphone mechanocardiography detection of AF against visual interpretation of telemetry electrocardiographic recordings in hospitalized patients.

For the present case-control study, 150 consecutive patients in AF and 150 age- and sex-matched patients in sinus rhythm (SR) were enrolled from the cardiology and internal medicine wards of Turku University Hospital, Finland, between April and September 2017. After informed consent was obtained, a 3-minute mechanocardiography recording was acquired from each subject with a Sony Xperia smartphone placed on the sternum, and a simultaneously obtained 5-lead telemetry electrocardiography (Philips IntelliVue MX40) recording was used as the comparison method to assess rhythm and the number of supraventricular and ventricular extrasystoles. Electrocardiographic rhythm classifications were confirmed by 2 independent cardiologists, and a third cardiologist made the final decision if interpretations diverged. In addition, physical measurements were recorded, and electronic patient records were searched for the subjects’ clinical history and investigations conducted during the index hospitalization. The institutional ethics review board approved the study protocol.

The mechanocardiography recordings were analyzed with an algorithm developed beforehand …

由于经常出现无症状的房颤（AF），因此中风常常是其首发表现。¹为了有效预防中风，及时诊断房颤至关重要。移动设备无处不在，为筛选应用程序提供了巨大的可能性。在机械心动图中，心脏机械活动是通过加速度计和陀螺仪（现代智能手机的标准组件）进行记录的。²在我们之前的概念验证研究中，智能手机心电图表明在39个受试者中检测AF的敏感性为94％，特异性为100％。²在这里，我们验证了针对住院患者的遥测心电图记录的可视化解释的智能手机心电图检测房颤。

对于本病例对照研究，于2017年4月至2017年9月之间，从芬兰图尔库大学医院的心脏病和内科病房招募了150名连续性AF患者和150名年龄和性别相匹配的窦性心律（SR）患者。在获得知情同意后，使用放置在胸骨上的Sony Xperia智能手机从每个受试者获取3分钟的心电图记录，并将同时获得的5导联遥测心电图（Philips IntelliVue MX40）记录用作比较方法，以评估节律和室上和室上收缩期的数量。2位独立的心脏病专家确认了心电图节律分类，如果解释不同，则由第三位心脏病专家做出最终决定。此外，记录身体测量结果，并搜索电子患者记录以了解受试者的临床病史和在指数住院期间进行的检查。机构伦理审查委员会批准了研究方案。

使用预先开发的算法对心电图记录进行分析...