Evidence map›Paper›PMID 40680808›Full record

ArticleAmerican heart journal2025

Active Monitoring for AtriaL FIbrillation (AMALFI): Rationale, protocol, and pilot for a pragmatic, randomized, controlled trial of remote screening for asymptomatic atrial fibrillation.

Rohan Wijesurendra, Guilherme Pessoa-Amorim, Georgina Buck, Charlie Harper, Richard Bulbulia, Nicholas R Jones, Christine A'Court, Rijo Kurien, Karen Taylor, Barbara Casadei and 1 more

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in American heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Rohan WijesurendraClinical Trial Service and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. Electronic address: rohan.wijesurendra@ndph.ox.ac.uk.
Guilherme Pessoa-AmorimClinical Trial Service and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Georgina BuckClinical Trial Service and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Charlie HarperClinical Trial Service and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Richard BulbuliaClinical Trial Service and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Nicholas R JonesNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Christine A'CourtNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Rijo KurienClinical Trial Service and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Karen TaylorClinical Trial Service and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Barbara CasadeiNational Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK.
Louise BowmanClinical Trial Service and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesScreening for asymptomatic atrial fibrillation (AF) might reduce cardioembolic strokes and screening for asymptomatic AF is recommended by some international guidelines. However, any impact of AF screening on clinical outcomes depends on a sustained increase in AF detection and anticoagulation use over time than would have occurred with routine care alone, highlighting the importance of long-term studies to generate the evidence needed to justify establishing formal screening programs. AMALFI aims to establish the long-term efficacy and cost-effectiveness of remote screening for asymptomatic AF in older individuals at increased risk of stroke using a noninvasive 14-day continuous ECG monitoring patch in UK primary care. This paper describes the study protocol and baseline characteristics of included participants.

methodsAMALFI (ISCRTN 15544176) recruited individuals aged ≥65 years with CHA

resultsBetween 2019 and 2022, AMALFI randomized 5,040 people in England to screening versus usual care using mail-based invitations. Participant mean age was 77 ± 6 years, with 2360 (46.8%) female; median CHA

conclusionAMALFI will provide randomized evidence on the actionable time window of opportunity for intervention generated by remote screening for asymptomatic AF in the UK using a noninvasive long-term continuous monitoring ECG patch, and the cost-effectiveness of this approach. Such data may further elucidate existing patterns of routine AF diagnosis and management, and provide important insights to guide future discussions into nationwide AF screening in the UK. AMALFI results will be reported in 2025 and 2027.

Indexed as

Atrial FibrillationElectrocardiography, AmbulatoryMass ScreeningStrokeAgedAsymptomatic DiseasesCost-Benefit AnalysisElectrocardiographyFemaleHumansMalePilot ProjectsPragmatic Clinical Trials as TopicPrimary Health CareRandomized Controlled Trials as TopicUnited Kingdom

Identifiers

PMID40680808
PMCPMC7618845

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.