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The Dutch-GERAF study will address two major issues. Firstly, the effectiveness and feasibility of an opportunistic screening strategy for clinical AF will be assessed in frail older patients and, secondly, observational data will be gathered regarding the efficacy and safety of oral anticoagulation (OAC).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This is a\u00a0multicentre study on opportunistic screening of geriatric patients for clinical AF using a\u00a0smartphone photoplethysmography (PPG) application. Inclusion criteria are age \u2265\u202f65\u00a0years and the ability to perform at least three PPG recordings within 6\u00a0months. Exclusion criteria are the presence of a\u00a0cardiac implantable device, advanced dementia or a\u00a0severe tremor. The PPG application records patients\u2019 pulse at their fingertip and determines the likelihood of clinical AF. If clinical AF is suspected after a\u00a0positive PPG recording, a\u00a0confirmatory electrocardiogram is performed. Patients undergo a\u00a0comprehensive geriatric assessment and a\u00a0frailty index is calculated. Risk scores for major bleeding (MB) are applied. Standard laboratory testing and additional laboratory analyses are performed to determine the ABC-bleeding risk score. Follow-up data will be collected at 6\u00a0months, 12\u00a0months and 3\u00a0years on the incidence of AF, MB, hospitalisation, stroke, progression of cognitive disorders and mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Discussion<\/jats:title>\n                <jats:p>The Dutch-GERAF study will focus on frail older patients, who are underrepresented in randomised clinical trials. It will provide insight into the effectiveness of screening for clinical AF and the efficacy and safety of OAC in this high-risk population.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>NCT05337202.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s12471-024-01868-6","type":"journal-article","created":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T15:02:20Z","timestamp":1713193340000},"page":"200-205","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Design of the Dutch multicentre study on opportunistic screening of geriatric patients for atrial fibrillation using a\u00a0smartphone PPG app: the Dutch-GERAF study"],"prefix":"10.1007","volume":"32","author":[{"name":"Dutch-GERAF investigators","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9587-7507","authenticated-orcid":false,"given":"Lennaert A. 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J.R.\u00a0de Groot and M.E.W.\u00a0Hemels received speakers fees from Roche Diagnostics, Bayer, BMS\/Pfizer, Boehringer Ingelheim, Daiichi Sankyo. L.A.R.\u00a0Zwart, J.R.\u00a0Spruit, R.\u00a0Pisters, and R.W.M.M.\u00a0Jansen declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}