Supermarket Trolleys are Being Used to Look for Major Cardiac Problems

It’s possible that the trip to the store will save your life: Atrial fibrillation can be diagnosed and treated using supermarket trolleys, thereby preventing strokes that cause disability or death. The study will be presented at the European Society of Cardiology (ESC) scientific congress ACNAP 2023 today.

The study’s lead author, Professor Ian Jones of Liverpool John Moores University in the United Kingdom, stated, “This study shows the potential of taking health checks to the masses without disrupting daily routines. Over the course of two months, we identified 39 patients who were unaware that they had atrial fibrillation. That’s 39 people at greater risk of stroke who received a cardiologist appointment.”

The most prevalent heart rhythm disorder, atrial fibrillation, affects over 40 million people worldwide. Stroke risk is five times higher with atrial fibrillation. These strokes frequently result in death or disability. Although anticoagulation significantly reduces risk, atrial fibrillation is frequently only discovered after a stroke. As a result, screening programs are required to identify individuals with the condition and provide them with preventative medication.

The SHOPS-AF study looked into whether atrial fibrillation patients could be accurately identified by embedding electrocardiogram (ECG) sensors into supermarket trolley handles. During the two-month study, ten trolleys with a sensor in the handle were used in four Liverpool supermarkets and pharmacies.

Customers were instructed to make use of a modified trolley and to hold the handlebar for at least 60 seconds. It lit up green if the sensor did not detect an irregular heartbeat. A researcher performed a manual pulse check on these participants to ensure that they did not have atrial fibrillation. The sensor turned red if it detected an irregular heartbeat. The participant remained still while the in-store pharmacist performed a manual pulse check and another sensor reading with a stand-alone bar that was not attached to a trolley. Participants whose ECGs showed a red light or an irregular pulse were examined by the study’s cardiologist. The findings, which included the following: 1) no atrial fibrillation; 2) An invitation to repeat the measurement and an unclear ECG; or on the other hand 3) atrial fibrillation affirmed and a cardiologist appointment in two weeks or less.

2,155 adults used a shopping trolley in total. 220 participants with a red sensor light and/or an irregular pulse, both of which are signs of atrial fibrillation, had access to ECG data. 115 participants had no evidence of atrial fibrillation after the study cardiologist reviewed their electrocardiograms, 46 had recordings that were unclear, and 59 had been diagnosed with the condition. The 59 participants with atrial fibrillation had an average age of 74 years, and 43% of them were women. Twenty of them knew they had atrial fibrillation, and 39 had never been diagnosed before.

The researchers carried out three analyses in order to evaluate the accuracy of this method of screening: 1) excluding all 46 ECGs that are unclear; 2) Assuming atrial fibrillation was the cause of all unclear ECGs; and 3) assuming that there was no atrial fibrillation in any of the unclear ECGs. This demonstrated that the sensor’s specificity was 0.15 to 0.97 and its sensitivity was 0.70 to 0.93. This led to a positive predictive value of 0.24 to 0.56, indicating that there were a high number of false positives and that only one-quarter to one-half of those who were found to have atrial fibrillation through the sensor and/or manual pulse check actually had the condition. The negative predictive value ranged from 0.55 to 1.00, indicating that this approach would miss approximately half of actual cases of atrial fibrillation (also known as false negatives).

In the end, he said: “Checking for atrial fibrillation while people do their regular shopping holds promise for preventing strokes and saving lives. A crucial aspect is providing immediate access to a health professional who can explain the findings and refer patients on for confirmatory tests and medication if needed.”