The Lead Episode 127 (IH): A Discussion of Remote Screening for Asymptomatic Atrial Fibrillation: The AMALFI Randomized Clinical Trial, LIVE at HRX 2025 (IH)-A Discussion of Remote Screening for Asymptomatic Atrial Fibrillation: The AMALFI Randomized Clinical Trial (IH) (Bonsu Video)

A Discussion of Remote Screening for Asymptomatic Atrial Fibrillation: The AMALFI Randomized Clinical Trial (IH) (Bonsu Video)

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Video Transcription

Video Summary

In this episode of The LEAD Podcast, Melissa Middeldorp discusses the MALFI randomized clinical trial with experts Emma Svenberg and Rod Pasman. The MALFI trial studied remote screening for asymptomatic atrial fibrillation (AF) in high-risk individuals aged 65+ with CHADS-VA scores ≥3. Participants were randomized to wear a 14-day ECG patch or receive usual care. The study enrolled about 5,000 participants remotely, with high adherence to patch use. AF detection was 6.8% in the screening group versus 5.7% in controls, a smaller difference than expected due partly to heightened awareness in controls. Most AF was detected early, often within the first week. While the trial confirmed feasibility and effectiveness of remote AF detection, it was underpowered for outcomes like stroke or heart failure. The discussion highlighted challenges in defining anticoagulation thresholds for brief AF episodes and stressed the need for larger outcome-driven trials to optimize screening strategies and improve patient care.

Keywords

MALFI trial

atrial fibrillation screening

remote ECG patch

high-risk elderly

clinical trial outcomes