The throne of health care: detection of cardiac arrhythmias on a toilet-seat

Thilo C, Achenbach S, Lueg C, Kochinke L, Kaufmann J, Pfeiffer N, Lang-Richter NR, Zech TS, Steiner A, Fiedelak S, Hartmann D, Stroebel A, Richter M, Schunkert H, Anneken L (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Clinical Research in Cardiology Springer Verlag (Germany)

DOI: 10.1007/s00392-026-03000-7

Abstract

Background: Early detection of atrial fibrillation (AF) may reduce the risk of complications such as stroke. This study evaluated the diagnostic performance of a toilet seat-integrated electrocardiogram (TS-ECG) for AF detection under controlled clinical conditions. Methods: This prospective multicentre feasibility study included 83 participants (mean age 64 years, 55% male) recruited at two cardiology centres in Germany. Participants were assigned to sinus rhythm (n = 50), AF (n = 28), or other non-AF arrhythmias (n = 5). Each participant underwent simultaneous recordings using a standard 12-lead ECG and the TS-ECG. Recordings were independently interpreted by four experienced cardiologists blinded to device type. The primary endpoint was diagnostic agreement for AF detection between TS-ECG and the reference ECG. Results: Compared with the 12-lead ECG, the TS-ECG demonstrated a mean sensitivity of 96% (95% CI: 93–98%) and specificity of 95% (92–97%) across readers. When majority voting was applied, sensitivity increased to 99% (98–100%) and specificity to 97% (96–99%). Overall diagnostic accuracy was high across all readers. Conclusion: The TS-ECG demonstrated high diagnostic agreement with standard 12-lead ECG for AF detection under controlled clinical conditions. These findings support further evaluation of the system in longitudinal and home-based studies to assess real-world feasibility and clinical utility. Trial Registration: DRKS00035167.

Authors with CRIS profile

Stephan Achenbach Lehrstuhl für Innere Medizin II Lars Anneken Department of Medicine 2 – Cardiology and Angiology

Involved external institutions

RoMed Kliniken - Kliniken der Stadt und des Landkreises Rosenheim GmbH DE Germany (DE) Fraunhofer-Institut für Integrierte Schaltungen (IIS) DE Germany (DE) Hamberger Sanitary GmbH DE Germany (DE) Klinikum der Universität München (LMU Klinikum) DE Germany (DE)

How to cite

APA:

Thilo, C., Achenbach, S., Lueg, C., Kochinke, L., Kaufmann, J., Pfeiffer, N.,... Anneken, L. (2026). The throne of health care: detection of cardiac arrhythmias on a toilet-seat. Clinical Research in Cardiology. https://doi.org/10.1007/s00392-026-03000-7

MLA:

Thilo, Christian, et al. "The throne of health care: detection of cardiac arrhythmias on a toilet-seat." Clinical Research in Cardiology (2026).

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