Smartwatch-guided, time-limited blood thinner use for atrial fibrillation

The Rhythm Evaluation for Anticoagulation with Continuous Monitoring of Atrial Fibrillation Trial (REACT-AF)

['FUNDING_OTHER'] · NORTHWESTERN UNIVERSITY · NIH-11163342

This will compare taking a blood thinner continuously versus taking it only for short periods after an Apple Watch detects an hour of atrial fibrillation in people with paroxysmal or persistent AF and low-to-moderate stroke risk.

Quick facts

Phase['FUNDING_OTHER']
Study typeNih_funding
SexAll
SponsorNORTHWESTERN UNIVERSITY (nih funded)
Locations1 site (CHICAGO, UNITED STATES)
Trial IDNIH-11163342 on ClinicalTrials.gov

What this research studies

You would be randomly assigned to either take a direct oral anticoagulant (DOAC) every day like current care or to take the DOAC only when your smartwatch detects an atrial fibrillation episode lasting one hour or more. The trial uses an AF-capable smartwatch (Apple Watch) to continuously monitor heart rhythm and trigger time-limited anticoagulation in the smartwatch-guided group. It is a multicenter, open-label study with blinded assessment of outcomes, and will follow participants for stroke, bleeding, and other major events. The study focuses on people with paroxysmal or persistent AF who have a low-to-moderate risk of stroke (CHA2DS2-VASc score 1–4).

Who could benefit from this research

Good fit: Ideal candidates are adults with paroxysmal or persistent atrial fibrillation, a CHA2DS2-VASc score of 1–4, and the ability to wear and sync an AF-capable smartwatch.

Not a fit: People with high stroke risk, permanent AF, mechanical heart valves, other clear indications for continuous anticoagulation, or those unable/unwilling to use a smartwatch are unlikely to benefit from this approach.

Why it matters

Potential benefit: If successful, this approach could lower bleeding risk and improve quality of life by avoiding unnecessary continuous anticoagulation while preserving protection against stroke.

How similar studies have performed: Smaller observational studies and pilot efforts have suggested rhythm-triggered anticoagulation could reduce bleeding, but this large randomized trial is a new test of the strategy.

Where this research is happening

CHICAGO, 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.

View on NIH RePORTER →

Last reviewed 2026-05-15 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.