Smartwatch-guided blood thinner use for atrial fibrillation

2/2 REACT-AF: Rhythm Evaluation for AntiCoagulaTion with Continuous Monitoring of Atrial Fibrillation

NIH-funded research Johns Hopkins University · NIH-11158776

This compares taking blood thinners continuously versus only after an Apple Watch detects at least one hour of atrial fibrillation for people with paroxysmal or persistent AF and low-to-moderate stroke risk.

Quick facts

Grant typeNIH-funded research
Study typeNIH-funded research
Funding institutionJohns Hopkins University NIH-funded
Lab location1 site (Baltimore, United States)
Project IDNIH-11158776 on NIH RePORTER

What this research studies

If you join, you'll be randomly assigned to either take a direct oral anticoagulant (DOAC) all the time or to take short, time-limited DOAC courses only when your Apple Watch detects at least one hour of AF. The watch will continuously monitor your heart rhythm and trigger treatment when AF episodes meet the study threshold. Doctors will track strokes, bleeding events, and other outcomes over the follow-up period. The trial enrolls people with paroxysmal or persistent AF and a CHA2DS2-VASc score of 1-4 at multiple U.S. centers led by Johns Hopkins.

Who could benefit from this research

Good fit: People with paroxysmal or persistent atrial fibrillation, a CHA2DS2-VASc score of 1-4, able and willing to wear an Apple Watch and take DOACs as directed.

Not a fit: People with high stroke risk, permanent continuous AF, inability to use a smartwatch, or contraindications to DOACs are unlikely to benefit from this trial approach.

Why it matters

Potential benefit: If successful, this approach could lower bleeding risk while still protecting against stroke by matching blood thinner use to actual AF episodes.

How similar studies have performed: Smartwatch detection of AF has been validated in prior work, but using smartwatch-triggered, time-limited anticoagulation is a novel strategy not yet proven in large randomized trials.

Where this research is happening

Baltimore, United States

Researchers

About this research

  1. This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
  2. Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
  3. For full project details, budget, and progress reports, visit the official NIH RePORTER page below.
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.