Aims Atrial fibrillation (AF) is a preventable cause of ischaemic stroke but it is often undiagnosed and undertreated. The utility of smartphone electrocardiogram (ECG) for the detection of AF after ischaemic stroke is unknown. The aim of this study is to determine the diagnostic yield of 30-day smartphone ECG recording compared with 24-h Holter monitoring for detecting AF ≥30 s. Methods and results In this multicentre, open-label study, we randomly assigned 203 participants to undergo one additional 24-h Holter monitoring (control group, n = 98) vs. 30-day smartphone ECG monitoring (intervention group, n = 105) using KardiaMobile (AliveCor®, Mountain View, CA, USA). Major inclusion criteria included age ≥55 years old, without known AF, and ischaemic stroke or transient ischaemic attack (TIA) within the preceding 12 months. Baseline characteristics were similar between the two groups. The index event was ischaemic stroke in 88.5% in the intervention group and 88.8% in the control group (P = 0.852). AF lasting ≥30 s was detected in 10 of 105 patients in the intervention group and 2 of 98 patients in the control group (9.5% vs. 2.0%; absolute difference 7.5%; P = 0.024). The number needed to screen to detect one AF was 13. After the 30-day smartphone monitoring, there was a significantly higher proportion of patients on oral anticoagulation therapy at 3 months compared with baseline in the intervention group (9.5% vs. 0%, P = 0.002). Conclusions Among patients ≥55 years of age with a recent cryptogenic stroke or TIA, 30-day smartphone ECG recording significantly improved the detection of AF when compared with the standard repeat 24-h Holter monitoring.

BACKGROUND: Reports on healthcare worker antibody response to COVID-19 infection are scarce. We aim to determine the COVID-19 antibody prevalence among healthcare workers in a cardiology centre and the relationship between case definition criteria with the COVID-19 antibody result. METHODS: Convenience sampling was applied. Healthcare workers in Sarawak Heart Centre (SHC) cardiology, radiology, and emergency unit were recruited. A survey form on clinical symptoms and close contact history was distributed. HEALGEN COVID-19 IgG/IgM rapid test was performed using serum/ whole blood specimen. Staff with positive COVID-19 antibody results were referred to the infectious disease specialist for assessment. RESULTS: A total of 310 staff were screened. 220(71%) were female, and the mean age was 36±7.7 years old. 46(14.8%) staff reported having clinical symptoms at some stage from the end of January 2020 to the time of this surveillance. Number of staff who had a history of overseas travel, close contact with confirmed COVID-19 patients, or had visited places with identified COVID-19 clusters were 4(1.3%), 24(7.7%) and 24(7.7%) respectively. There were 14 staff (4.5%) with positive tests positive, 2 for IgM, and 12 for IgG. All those with positive antibody were subsequently tested negative with RT-PCR test. The history of having clinical symptoms and exposure to COVID-19 cluster area were independently associated with a positive IgG result. CONCLUSION: The application of COVID-19 antibody serology rapid tests could determine true exposure of staff to the infection and allow us to reassess existing measures of infection control within the hospital.

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