Overview

• The AMALFI randomized trial enrolled 5,040 UK primary-care patients aged 65 and older, mailing 14‑day iRhythm Zio XT patches for an entirely remote screening strategy.
• AF was diagnosed in 6.8% of the screening group versus 5.4% with usual care at 2.5 years (P = .03), with earlier diagnoses in the patch group (median 103 days versus 530 days).
• During monitoring, the patch directly detected AF in 4.2% of participants, over half had low AF burden under 10%, and more than half of detections occurred on day one.
• Exposure to anticoagulants was higher with screening (1.63 vs 1.14 months), while stroke rates were similar between groups (2.7% vs 2.5%).
• Adherence was high with about 85% wearing and returning patches, and results were presented at the European Society of Cardiology Congress with simultaneous publication in JAMA.