Atrial fibrillation, a condition where the heart rhythm becomes irregular and often rapid, is a major global health issue affecting 59.7 million people worldwide. This condition increases the risk of serious complications, such as strokes, heart failure, and memory problems. To tackle these challenges, Dr. Kam Cheong Wong’s research from the University of Sydney offers a practical and innovative way to detect and manage this condition in communities. His approach connects the process of identifying atrial fibrillation directly with healthcare services, allowing for earlier detection and better outcomes for patients. By catching the condition early, individuals can work on reducing risks and avoiding serious health problems.
Dr. Wong designed a system to screen for atrial fibrillation in local communities using modern, portable electrocardiogram (ECG) devices that record heart rhythms. These devices are easy to use, even for older adults, and provide quick results. In a large study, participants used the devices to record their heart rhythms over several months. The results showed that handheld single-lead ECGs were very effective at identifying irregular heartbeats, almost matching the accuracy of conventional 12-lead ECG machines typically used in clinics and hospitals. Importantly, people using handheld single-lead ECG devices were far more likely to have their atrial fibrillation detected than those who only relied on routine visits to their doctors. Participants also found the devices easy and convenient, which helped ensure they kept using them as recommended.
Dr. Wong explained, “This community atrial fibrillation screening model was feasible, acceptable, and effective in diagnosing atrial fibrillation among older people who were independent in their daily living or had access to a support person.” This underscores how the screening system is designed to cater to the specific needs of the population it serves, ensuring accessibility and usability.
A key strength of Dr. Wong’s system was how well people adhered to the program. Nearly everyone who joined the six-month study completed it successfully. Participants were guided to record their heart rhythm regularly and received support to help them understand and use the technology. This high level of participation showed that the system could work well in real-life settings, especially with the proper training and communication to address any concerns or technical difficulties.
Dr. Wong’s research also examined how this type of screening fits into the bigger picture of healthcare. He reviewed similar programs worldwide and found that handheld single-lead ECGs are widely used. However, many earlier studies lacked of randomization and control groups. Dr. Wong’s work filled the gaps, showing how mobile ECG devices, combined with clear communication and follow-up, could be a reliable and practical tool for communities.
To better understand the challenges and successes of the program, Dr. Wong examined how people and healthcare systems interact. This approach revealed ways to improve the system, such as deciding how long people should use the devices and exploring how technology like artificial intelligence could help analyze the data. While computers can help make the process faster and more efficient, Dr. Wong emphasized that they should support healthcare workers rather than replace them. Personal care and trust remain essential in ensuring patients feel supported.
Another important part of the study was making sure the screening results were shared with the participants’ doctors. This allowed for smooth follow-up care, where doctors could use the screening results to help manage the condition effectively. The system also made it easy for doctors to include screening as part of regular health check-ups, ensuring it fits naturally into existing healthcare routines. This streamlined process means the program could work in many places, including areas with fewer resources.
“This screening approach and methodologies presented can be adapted to diverse contexts with varying resource availability by optimizing screening duration, utilizing cost-effective and accurate devices for atrial fibrillation diagnosis, and incorporating artificial intelligence for electrocardiogram interpretation,” Dr. Wong said, emphasizing the adaptability of his system to various healthcare environments.
Dr. Wong’s findings go beyond simply detecting atrial fibrillation. By showing how technology can improve healthcare delivery, his work opens the door for broader use of digital tools to tackle other health issues. His system is particularly useful for addressing challenges faced by aging populations, as it offers a simple and affordable way to manage chronic and potentially acute conditions. The flexibility of the approach means it can be adapted to meet the needs of different healthcare systems around the world, making it a valuable screening system integrated with continual care for improving global health.
Reflecting on the impact of his work, Dr. Wong stressed the importance of teamwork and open discussions in driving progress. “The integrated continual care approach encompasses clinical and data integration, enabling continuity of care. Clinical integration includes preventive health screening during assessments, followed by atrial fibrillation management, while data integration ensures documentation of results in medical records for future reviews,” he stated, highlighting the importance of building systems that connect all aspects of patient care.
Acknowledgement: A Collaborative Effort
Dr. Wong deeply values the environment that supported his work, highlighting the role of teamwork and the exchange of ideas. “Intellectual Discussion is the Genesis of Success: Significant accomplishments are often born out of the dynamic and stimulating environment catalyzed by disagreement and intellectual exchange,” he shared. This belief underscores the importance of sharing knowledge and working together to solve complex problems, which was a driving force throughout his research.
Thesis Reference
Wong, Kam Cheong. Atrial Fibrillation Screening in the Community: An Integrated Continual Care Approach. PhD Thesis, University of Sydney, 2024. The link: https://ses.library.usyd.edu.au/handle/2123/33258
Figure Reference
Kam Cheong Wong, Tu N Nguyen, Simone Marschner, Samual Turnbull, Anupama Balasuriya Indrawansa, Rose White, Mason Jenner Burns, Vishal Gopal, Haeri Min, Desi Quintans, Amy von Huben, Steven A Trankle, Tim Usherwood, Richard I Lindley, Saurabh Kumar, Clara K Chow, A randomized controlled implementation study integrating patient self-screening with a remote central monitoring system to screen community dwellers aged 75 years and older for atrial fibrillation, European Journal of Preventive Cardiology, Volume 31, Issue 18, December 2024, Pages 2104–2114, https://doi.org/10.1093/eurjpc/zwae312
About the Author
Dr. Kam Cheong Wong advocates for the integration of medicine and engineering and is dedicated to revolutionizing cardiovascular care through digital health innovation. As a Senior Research Fellow at the Westmead Applied Research Centre, University of Sydney, and Senior Lecturer at Bathurst Clinical School, Western Sydney University, Dr. Wong draws on an impressive 20 years of clinical expertise and a decade of engineering experience.
Holding a PhD in Medicine (University of Sydney), a Medical Degree (University of Queensland), and a Master of Science Degree and Bachelor of Engineering Degree (National University of Singapore), Dr. Wong focuses on applying digital health technology to enhance the early diagnosis and management of cardiovascular conditions. His research has demonstrated the real-world impact of remote health innovations, particularly in the screening and management of atrial fibrillation. Driven by a commitment to accessibility and practical solutions, Dr. Wong’s work bridges cutting-edge science with community-focused applications, ensuring heart health services for all.
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