The Post-Surgical Enhanced Monitoring for Cardiac Arrhythmias
and Atrial Fibrillation (SEARCH-AF) CardioLink-1 Trial

One-third of people who have heart surgery develop an irregular heartbeat, a condition known as atrial fibrillation. Stroke is a serious complication risk for all patients after surgery, but evidence suggests that individuals who develop atrial fibrillation after surgery have a 50 per cent higher long-term risk of stroke. The SEARCH-AF CardioLink-1 trial sought to compare early detection of AF with a continuously monitoring, wearable patch compared to usual care. Participants were enrolled from 10 cardiac surgical centres in 5 Canadian provinces. SEARCH-AF demonstrated that significantly more atrial fibrillation was detectable with the cardiac monitoring device than in normal care following discharge from hospital after cardiac surgery. These findings indicate that atrial fibrillation after cardiac surgery is not confined to the hospitalization period and may be an underappreciated burden that could benefit from additional medication to lower stroke risk. SEARCH-AF was invited as a Late-Breaking trial presentation at the 2020 American Heart Association (AHA) Annual Scientific Sessions and the primary results paper was published in JAMA Network Open (Ha et al. 2021). Of note, the SEARCH-AF results were in part the basis for new recommendations in the 2023 American College of Cardiology (ACC) / AHA Guideline for the Diagnosis and Management of Atrial Fibrillation.