Detection of Atrial Fibrillation Using PPG From Smartphone Cameras (FLASH AF)

August 19, 2026 updated by: Happitech BV

Detection of Atrial Fibrillation Using Photoplethysmography From Smartphone Cameras

The protocol is designed to enroll patients from at least 3 diverse clinical sites with smartphones who are being evaluated for the presence or absence of atrial fibrillation (AF) using the Heart Rhythm Software algorithm running on their smartphones. Algorithm output will be compared to a gold standard of 12-lead ECG recorded with a simultaneous PPG measurement.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide, and its prevalence is increasing and is expected to continue increasing for decades,. Detection of AF episodes may be useful for the identification of undiagnosed AF and in making clinical management decisions that include oral anticoagulation, restoration and maintenance of sinus rhythm, control of ventricular rate, and risk factor modification. Treatment of AF is associated with improvements of quality of life, stroke prevention, and reduced risk of heart failure.

Traditionally, diagnosis of AF is done using an electrocardiogram, with low amplitude or absent p-waves and narrow complex "irregularly irregular" pattern intervals seen on the ECG,. After diagnosis, there are a variety of methods that can be used to manage AF. Ambulatory ECG monitoring, implantable monitoring devices, and over-the-counter wrist-worn devices have been used to manage patients with AF,,. However, these devices are inconvenient and expensive which limits their wide adoption into clinical practice. There is an unmet clinical need for an easy to use and inexpensive over-the-counter FDA-cleared products that can detect episodes of AF in real-time and notify patients to seek out further care when AF is suspected.

Recent technological advancements have allowed for the identification of AF using smartwatches, with device manufacturers gaining over-the-counter regulatory clearance for their irregular heart rate detection algorithms,. These wrist-worn devices use a light-based measurement method called photoplethysmography (PPG) to measure changes in light absorbance and reflectance to understand changes in blood flow in superficial vasculature. The waveform generated from this measurement can be used to measure parameters like pulse rate, respiratory rate, pulse rate variability and others in addition to detecting AF. The increasing ubiquity of smartphones worldwide has led to greater availability of heart rhythm diagnostics using smartphone photoplethysmography (PPG). Smartphone camera PPG technology uses the light-emitting diode in cameras to measure pulsatile changes in light intensity that are reflected from a finger and can be used to detect AF. The widespread availability of this technology has the potential to improve the accessibility and convenience of heart rhythm monitoring, particularly in remote or underserved areas. This could result in improvements in early detection and management of AF, leading to better patient outcomes. Several smartphone PPG-based algorithms have been developed that utilize smartphones' built-in cameras to detect AF. The sensitivity and specificity of these algorithms for the detection of AF range between 81%-100% and 85%-100% respectively. However, there is a lack of evidence regarding the performance of these algorithms in detecting AF in an out-of-hospital setting using a gold-standard reference.

Happitech has developed a proprietary software development kit (SDK) that can be utilized to measure patients' cardiovascular parameters and identify potential pathologies including AF. Happitech's algorithm requires users to place a digit directly against their phone camera, and the camera and underlying algorithm detect subtle differences in blood flow to calculate physiological parameters for monitoring and clinical use.

The purpose of this study is to validate the performance of Happitech's PPG-based algorithm for the detection of AF against a 12-lead ECG in a diverse population of patients including cardiology patients being evaluated as inpatients or at a cardiology clinic visit.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
554

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Netherlands
    • Overijssel
      • Zwolle, Overijssel, Netherlands, 8025 AB
        • Recruiting
        • Isala Zwolle
        • Contact:
        • Principal Investigator:
          • Sebastien Krul, Doctor
  • United States
    • Arkansas
      • Jonesboro, Arkansas, United States, 72401
        • Recruiting
        • Nair Research, LLC dba Arrhythmia Research Group LLC
        • Contact:
        • Principal Investigator:
          • Devi Nair, Doctor
    • Colorado
      • Littleton, Colorado, United States, 80210
        • Recruiting
        • South Denver Cardiology
        • Contact:
        • Principal Investigator:
          • Srikanth Sundaram, Doctor
    • Louisiana
      • New Orleans, Louisiana, United States, 70112
        • Not yet recruiting
        • Tulane University
        • Contact:
          • Kunal Sameer, Associate Director of Ops
          • Phone Number: 203-285-5666
          • Email: ksameer@tulane.edu
        • Principal Investigator:
          • Nassair Marrouchi, Doctor
    • Oklahoma
      • Oklahoma City, Oklahoma, United States, 73134
        • Recruiting
        • CardioVascular Health Clinic
        • Contact:
        • Principal Investigator:
          • Monica Lo, Doctor

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Male and female patients aged 22 years or older who are cardiology patients consulting the cardiac outpatient clinic, 50% of whom have a rhythm of atrial fibrillation at the time of enrollment, and own a smartphone.

Description

Inclusion Criteria:

  1. Adults aged 22 years or older
  2. Owns a smartphone and knows how to operate and navigate different applications.
  3. Individuals able to read, understand, and sign the consent form.
  4. Cardiology patients consulting the cardiac outpatient clinic.
  5. History of persistent AF or other cardiac rhythm

Exclusion Criteria:

  1. Participants with cognitive impairments
  2. Individuals who cannot read, speak, and/or understand English
  3. Patients with implantable neurostimulators, cardiac implantable device in an atrial or ventricular paced rhythm documented on a 12-lead ECG during the initial study visit

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Sinus Rhythm
Patient visiting the Cardiology Clinic in Sinus Rhythm
Diagnostic test: 12 Lead ECG is compared to a smartphone based PPG
12 Lead ECG is compared to a smartphone based PPG
Atrial Fibrillation
Patient visiting the Cardiology Clinic in Atrial Fibrillation
Diagnostic test: 12 Lead ECG is compared to a smartphone based PPG
12 Lead ECG is compared to a smartphone based PPG
Other
Patient visiting the Cardiology Clinic with neither Sinus Rhythm or Atrial Fibrillation
Diagnostic test: 12 Lead ECG is compared to a smartphone based PPG
12 Lead ECG is compared to a smartphone based PPG

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
To evaluate the sensitivity and specificity of the Heart Rhythm Software
Time Frame: Through study completion, an average of 6 months

To evaluate the sensitivity and specificity of the Heart Rhythm Software algorithm running on a commercially available smartphone to detect atrial fibrillation segments using photoplethysmography (PPG) as measured through the phone's camera.

Se is defined as the percentage of patients with 90 second interval recordings scored by the Heart Rhythm Software algorithm as AF, out of all intervals determined by the Clinical Adjudication Committee (CAC) to be AF (gold standard).

Sp is defined as the percentage of patients with 90 second intervals scored by the Heart Rhythm Software algorithm as NSR out of all ECG recordings determined by the CAC to be NSR.
Through study completion, an average of 6 months

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Sensitivity & Specificity across subgroups
Time Frame: through study completion, an average of 6 months
The accuracy of the Happitech Heart Rhythm Software algorithm in detecting irregular rhythm suspected of AF and regular rhythm suspected normal sinus rhythm will be further investigated in subgroups defined by ethnicity, race, BMI, age group, smartphone type, and Fitzpatrick scale score. The sensitivity and specificity will be presented as an estimate and associated 95% CI's, as well as a Chi-square or Fisher's Exact p-value to assess if all levels of the subgroup are homogeneous.
through study completion, an average of 6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Happitech BV

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 30, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 1, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
November 1, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 11, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 19, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
August 21, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
August 21, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 19, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • HAPP-CTP-FDA-2025-002

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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