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Insights From the eBRAVE-AF Trial","","Atrial fibrillation screening can reduce stroke and hospitalization risk, and current guidance supports oral anticoagulation when annual stroke risk is high. Yet prior digital AF trials enrolled mainly younger, low-comorbidity participants. In the eBRAVE-AF substudy, a smartphone photoplethysmography approach was compared with usual care in an elevated-risk population, assessing whether the strategy effectively reached those most likely to benefit. Digital screening more than doubled detection of treatment-relevant AF, but high-risk participants eligible for oral anticoagulation remained underrepresented.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/does-digital-screening-for-atrial-fibrillation-reach-its-target-group-insights-from-the-ebrave-af-trial/414490/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/does-digital-screening-for-atrial-fibrillation-reach-its-target-group-insights-from-the-ebrave-af-trial/414490.png","ImageObject",300,407,{"name":92,"@type":93},"Theodore","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What clinical question does the report address?","Question",{"text":113,"@type":114},"It asks whether digital screening for atrial fibrillation reaches the intended high-risk target group that most needs the technology.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What is the main finding regarding screening reach?",{"text":118,"@type":114},"Digital screening did not reach the high-risk group primarily in need of the technology, showing underrepresentation of patients indicated for oral anticoagulation.",{"name":120,"@type":111,"acceptedAnswer":121},"How was digital screening implemented and what was the key endpoint?",{"text":122,"@type":114},"Participants used a photoplethysmography-based smartphone method to detect pulse irregularities, with abnormal findings confirmed by Holter-electrocardiogram. The primary endpoint was newly diagnosed AF with initiation of oral anticoagulation within 6 months.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},414490,1791039419,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":39,"preview_page_count":4},7971461740886,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","JA CC: ADVANCES VOL . 5, NO . 1, 2026  \n© 2026 THE AUTHORS . PUBLISHED BY ELSE VIE R ON BEHALF OF THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION . THIS IS AN OPEN ACCESS ARTICLE UNDER THE CC BY LICENSE ( [http://creative commons . org/licenses/by/4 . 0/](http://creative commons . org/licenses/by/4 . 0/) ) .  \nBRIEF REPORT  \nDoes Digital Screening for Atrial Fibrillation Reach its Target Group? Insights From the eBRAVE-AF Trial  \nLuisa Freyer, MD,a,b Peter Spielbichler, MD,a Lukas Tenbrink,a Laura Elisa Villegas Sierra, MD,a Maria F. Vogl,a Theofanis Korovesis, MD,a Mathias Klemm, MD,a,b Steffen Massberg, MD,a,b Axel Bauer, MD,c  \nKonstantinos D. Rizas, MDa,b  \nA  \ntrial fibrillation (AF) is the most common arrhythmia and is associated with increased risk of stroke and hospitalization.1 Several  \nstudies identified demographic parameters and cardiovascular conditions as risk factors for developing AF.1 Timely detection of AF can substantially reduce morbidity and mortality.1 Particularly the annual stroke risk, estimated by CHA2DS2-VA(Sc) score, can be significantly lowered through early initiation of oral anticoagulation (OAC) . Current guidelines recommend considering the initiation of OAC in patients with estimated annual stroke risk of $1%, corresponding to a CHA2DS2-VA score of $1.1 Screening for AF has been proven effective not only in detecting unknown AF cases but also in identifying patients with known, untreated AF, which led to a significant net clinical benefit in previous studies.2 The adoption of smart-devices with pulse-measurement capabilities in everyday life has prompted the conduction of several digital AF-screening trials.3 ,4 However,  \nWhat is the clinical question being addressed?  \nDoes digital screening for atrial fibrillation reach its target group?  \nWhat is the main finding?  \nDigital screening for AF does not reach the high-risk group primarily in need of this technology.  \nthese studies predominantly enrolled young participants without relevant comorbidities and a median CHA2DS2-VASc score of 1.3 ,4 High-risk participants with indication for OAC after detection of AF were underrepresented. Thus, enrollment of an elderly population that could benefit from digital AF screening remains a major challenge. eBRAVE-AF (eHealth-based Bavarian Alternative Detection of Atrial Fibrillation)5 was the first trial to randomly assess the efficacy of smartphone-based screening to detect treatment-relevant AF in direct comparison with usual care in an elevated-risk population. In this substudy, we investigated whether the digital AFscreening strategy effectively reached its intended population and found that the high-risk population was underrepresented.  \nIn eBRAVE-AF, 67,488 policyholders of a German health insurance company (age 50-90 years, CHA2DS2-VA score $1, without known AF or OAC) were invited to participate. Of those invited, 5,551 individuals (8.2%) consented and were randomized to digital screening or usual care. For digital screening, participants used a photoplethysmography-based screening method to detect pulse irregularities. Abnormal findings were confirmed by Holter-electrocardiogram. The primary endpoint was newly diagnosed AF with initiation ofOAC within 6 months. The type of OAC was atthe discretion of the treating physician and both directoral anticoagulants, as well as vitamin-K antagonists  \nFrom the aMedizinische Klinik und Poliklinik I, University Hospital Munich, Ludwig-Maximilians University, Munich, Germany; bMunich Heart Alliance, German Center for Cardiovascular Research (DZHK), Munich, Germany; and the cUniversity Hospital for Internal Medicine III, Medical University of Innsbruck, Innsbruck, Austria.  \nThe authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the Author Center.  \nISSN 2772-963X [","cbCaiuVfXtsq9L1h","https://ap.wps.com/l/cbCaiuVfXtsq9L1h","pdf",644971,"English","# Brief report\n## Clinical question and main finding\n## Study design and population\n## Screening method and endpoints\n## Outcomes and follow-up","[{\"question\":\"What clinical question does the report address?\",\"answer\":\"It asks whether digital screening for atrial fibrillation reaches the intended high-risk target group that most needs the technology.\"},{\"question\":\"What is the main finding regarding screening reach?\",\"answer\":\"Digital screening did not reach the high-risk group primarily in need of the technology, showing underrepresentation of patients indicated for oral anticoagulation.\"},{\"question\":\"How was digital screening implemented and what was the key endpoint?\",\"answer\":\"Participants used a photoplethysmography-based smartphone method to detect pulse irregularities, with abnormal findings confirmed by Holter-electrocardiogram. The primary endpoint was newly diagnosed AF with initiation of oral anticoagulation within 6 months.\"}]","Does Digital Screening for Atrial Fibrillation Reach its Target Group? Insights From the eBRAVE-AF Trial | PDF",1790597693]