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


The purpose of this study is to assess whether AFSW-guided, time-delimited DOAC therapy is non-inferior to continuous DOAC therapy for a composite endpoint that includes: (1) Ischemic stroke; (2) Systemic embolism; (3) All-cause mortality.

Study Arms

  • Experimental Arm (AF-SW Guided DOAC)
  • Control Arm (Continuous DOAC therapy)


  • 22-85 years of age.
  • English speaking participants*
  • Documented history of symptomatic or asymptomatic paroxysmal or persistent AF. The duration of AF must have been > 30 seconds as documented by an external monitor or present on 12-lead ECG.
  • CHA2DS2-VASC score of 1-4 without prior stroke or TIA**
  • The participant is on a DOAC at the time of screening.
  • Willing and able to comply with the protocol, including:
    • Possession of a smartwatch-compatible smartphone (iPhone that supports the latest shipping iOS) with a cellular service plan
    • Be willing to wear the smartwatch at least 14 hours a day
    • Expected to be within cellular service range at least 80% of the time
  • Willing and able to discontinue DOAC
  • The participant is willing and able to provide informed consent.