Exploring the Potential of Virtual Agents in Atrial Fibrillation Management: Insights from a Randomized Trial

Smartphone-based conversational agents offer a convenient way to deliver health education, particularly for managing complex health conditions such as chronic diseases. The present study explores using a smartphone-based virtual agent system to aid patients with a chronic heart condition—atrial fibrillation—to manage their health by encouraging the use of a heart rhythm sensor integrated with their smartphones. We report the results of a randomized clinical trial with 240 patients experiencing atrial fibrillation who were provided with smartphones and heart rhythm sensors for 4 months. Participants in the intervention group interacted with a virtual agent, while the control group received general health education via the WebMD app. Intervention participants completed a median 91 interactions with the agent over the 4 months of the study period, and agent features designed to increase engagement–such as storytelling–were effective at increasing use. The agent’s promotion of heart rhythm sensor use was effective, with intervention participants taking significantly more heart rhythm readings compared to those in the control group. Participants were followed for 8 months thereafter to assess the sustainability of the effects, specifically focusing on medication adherence.