Patients – taking part in the trial

Why have I been invited to take part?

Your GP practice has invited a random selection of patients aged 70 and over to take part in the trial. Any pre-existing medical conditions have not been taken into account.

Where can I find more information about AF?

For further information about AF please see the NHS Choices website.

I already know that I've got AF, or have had it in the past - can I still take part?

Yes you may be able to take part. An existing or previous diagnosis of AF will not necessarily exclude you from taking part – indeed we are particularly interested in people with an existing diagnosis of AF. However if you are currently taking blood thinning (anticoagulant) medication such as warfarin, edoxaban or rivaroxaban on a long-term basis for your AF then unfortunately you will not be able to take part. If you are taking an anticoagulant for a specific short-term reason (for example for surgery or a DVT) then you can take part. If you have any queries please contact the trial team.

I am taking aspirin / clopidogrel / ticagrelor / dipyridamole, can I still take part?

Yes you are able to take part if you currently take aspirin, clopidogrel, ticagrelor or dipyridamole. These are anti-platelet medications not anticoagulant medication – they thin the blood in a different way.

I have a medical history of cardiovascular disease, can I still take part?

Yes, your medical history has no bearing on your eligibility to take part. The only medical exclusion is if you are taking blood thinning (anticoagulant medication) on a long-term basis (see FAQ above for more details).

I have a pacemaker, can I still take part?

Yes you are able to take part if you have a pacemaker fitted. Please see the FAQ below about how to use the ECG device if you have a pacemaker.

Do I have to go to Cambridge, any other hospital, or my GP practice to take part?

No, you do not have to travel anywhere to take part in the trial. All aspects of taking part will be managed by post / phone.

Do I need a computer, mobile phone or WiFi / internet access to take part?

No. You do not need to have a computer, mobile phone, WiFi or internet access to take part in the trial or to use the ECG device.

How long will the trial last?

The overall trial will last for many years – currently anticipated to be 2028. However active involvement in the trial for participants will be lot shorter. For participants taking part in screening this will last for the duration of screening (3 weeks). Follow-up through NHS health records is currently planned to continue until 2028, however further funding may be secured to extend follow-up past this date.

Where will I be able to find the overall results of the trial?

A lay summary of the results of the trial will be published on the trial website. If you are a participant and would like a copy sending to you directly, please let the trial team know. The results will not be available until at least 2028.

How does the NHS share information from health records for research?

All NHS patient electronic health records are looked after by NHS Digital, who also manage access for research purposes. You can read more about what data NHS Digital holds and how it manages access here.

I have opted out of sharing data from my medical records for research and planning (National Data Opt-Out scheme). Can I still take part in the trial? Will my data be shared for the trial?

If you consent to the SAFER Trial, the research team should have access to relevant data from your medical records even if you have chosen to, or in the future choose to, opt-out of sharing your medical data for research and planning (National Data Opt-Out scheme). Your decision to take part in the SAFER Trial will not change access to your data for other research and planning purposes.

I returned my consent form a while ago but I haven't heard anything. Am I part of the trial?

We do not acknowledge receipt of consent as this would be very costly to do for such a large number of participants. If you do not hear from us you can assume you are part of the trial. If your practice does not offer screening for AF, and if we do not invite you to take part in any other aspect of the trial, you may not hear from us again. However please be assured that you are still part of the trial. Every patient who consents is playing a valuable part and enabling us to answer the research question.

How can I get involved in other research studies?

We have been asked by a few participants how they can take part in other research studies, so thought we would share some useful links.

The National Institute for Health Research (NIHR), who fund the SAFER programme, has a website for people who want to take part in a research study. They also have a brief film about being part of research.

The NIHR also have a website where you can search for studies that might interest you. There is also a link from there to sign up to be contacted about COVID-19 research studies.

The UK Biobank is another way to contribute to medical research.

More locally we are always keen to hear from people who want to get involved and support research activities at Addenbrooke’s Hospital and more widely at the Cambridge Biomedical Research Centre. The East of England Clinical Research Network also has information about taking part in research locally. Thiscovery are also recruiting people to various studies.

If you are interested in getting involved with other aspects of research, the Health Research Authority are recruiting people to sit on their NHS Research Ethics Committees.

Patients – screening for AF

I've been invited to take part in screening but I'm going away. Can I still do it?

Yes, we can arrange to post you the ECG device when you return, even if you are away for a few weeks.

I have been invited to take part in screening for AF for the trial, but I have AF and I am taking an anticoagulant medication. Am I still eligible to take part in screening?

Yes, if you have been invited to take part in screening for AF as part of the trial, you can do so regardless of whether you have AF, and regardless of any medication you may be taking. If you have any questions please get in touch with the research team.

Is the ECG device easy to use?

Yes! The ECG device is simple to use, and previous research studies have found that patients aged 70 and over found it easy to record and transmit the ECG traces, including people aged over 95 years. It is a small, handheld machine that you simply rest your thumbs or index fingers on to record an ECG. There are no wires or sticky pads involved. The recording process is adaptable for upper limb amputees.

You will be sent full written instructions with the device which can be found here. There is an instruction video that you can watch here (please note there is no need to enter any login details or password to view the video). The research team in Cambridge will be available to answer any questions you may have about using the device (please see the question below ‘how do I get help’).

Do I have to record my ECGs at specific times every day?

No. You can record the 4 ECGs whenever is convenient for you. They do not have to be recorded at the same time every day, nor spread out (evenly) across the day. Just whenever is most convenient for you.

I'm going out for the day, do I have to take the ECG device with me?

It is up to you whether you want to take the ECG device with you. It is portable and can be used whilst you are out and about (bear in mind you will need to be able to sit down quietly to record an ECG). If you would prefer not to take it with you, you can simply record ECGs before leaving home and/or on your return home.

I'm worried I will forget to record 4 ECGs every day. What can I do to try and remember to record?

Recording one at every meal time plus another before going to bed is one way to help you remember to record them. Alternatively, some people set reminders on their mobile phone. If you wish, you can also use the tally chart given to you with your ECG device. This will help you keep track of the number of ECGs recorded each day. You do not have to use the tally chart if you do not want to, it is up to you. If you use it you do not have to return it with your device.

What if I forget to record an ECG?

We would like you to use the device to record 4 ECGs per day, ideally. We realise that it is easy to forget to do one, and we have some suggestions for reminders above. If you forget to record an ECG, don’t worry. Just carry on doing them as usual.

I have a pacemaker. Can I use the ECG device?

It is safe to record ECGs with the device if you have a pacemaker. As the device contains a SIM card and transmits ECGs using a mobile phone network, we advise you to take the same precautions when sending ECGs as you do when using a mobile phone. These precautions may vary depending on the pacemaker, but in general involve avoiding having the ECG device close to your body when the device is transmitting ECGs. There is more information about this on the NHS website – click here. If you have any specific questions please get in touch with us.

What should I do if I am feeling unwell? Can I continue to record ECGs?

It is very important that if at any point you have symptoms you seek medical help in the same way that you usually would, for example by calling 999, or visiting your GP. Do not wait for the results of your screening test.

If you are feeling well enough to record ECGs please continue to do so. The ECG data will not be affected by an illness you may have or symptoms you may be experiencing.

If you are feeling unwell and not able to record ECGs, please don’t worry. Just start recording again as soon as you feel able to do so.

I am taking medication that lists arrhythmia (irregular heart beat) or other cardiac symptom as a possible side effect. Can I still record ECGs?

Yes, it does not matter what medication you may be taking, you can take part in screening and continue to record ECGs.

I only have one hand. Can I still record ECGs?

Yes, the ECG recording process is adaptable for participants who are missing upper limbs. Please ask the research team for guidance when we contact you to arrange delivery of the ECG device.

The ECG device does not always immediately register my thumbs / fingers and start the recording. Why is this and how do I get it to work?

Sometimes the device does not immediately register that you have placed your thumbs or fingers on the contact points, and does not start recording. This is usually because the skin on the hands is dry. You can achieve better connection with the electrodes (contact points) by washing and drying your hands prior to each recording, to dampen the skin. However do not use hand cream or lotion before recording, as this makes the connection between the electrodes and the skin worse.

What should I do if I don't have a good mobile signal at home?

The ECG device has an internal SIM card that uses the mobile network to transmit the ECG recordings. If you do not have a (strong) mobile signal at home, we advise you to keep recording 4 ECGs per day as usual: the device has a memory card that will store all the recordings safely. If the device consistently struggles to find a mobile signal (takes a long time to transmit, is unable to transmit, or gives an error message), please do not continue to attempt to transmit ECGs as this will drain the batteries. Instead please just attempt to transmit the stored ECGs every few days, or once per week, if you are able to transmit from a location with a stronger mobile signal. You can do this by switching the device on by pressing the START button, then pressing the SEND button. There is no need to record an ECG when transmitting.

If at the end of the 3 weeks (21 days) of recording you have been unable to transmit any ECGs, please DO NOT follow the instructions in the pack to return the device. Instead please call us (01223 763491) so that we can arrange a convenient time for the device to be collected (to reduce the risk of the device with all the stored ECGs going missing in the normal post back to us).

What should I do if I press the send button and get a message saying the ECG has not been sent?

This usually happens when there is a poor mobile signal (as the device uses an inbuilt SIM card to transmit the ECGs). There is no need to worry. Continue to record ECGs as normal. The ECGs will be stored safely on the device until they are sent.  If it keeps failing to send, please do not continue trying to send the ECGs after each recording. This will help preserve the battery life. When you are in a location with a stronger mobile signal you can try and press the send button again. If the device is able to pick up a mobile signal all stored ECGs will be transmitted. The strength of mobile signal appears in the top right hand corner of the screen whilst the device is transmitting.

How long do the batteries last? What should I do if the batteries run out?

The device will arrive with you with a fresh set of batteries fitted. This should be more than sufficient to last for the 3 weeks of screening. However if you are in a location with a poor mobile signal and the device is slow / unable to transmit ECGs, this will drain the batteries more quickly. In this situation continue to record ECGs as normal – see the previous FAQ ‘what should I do if I press the send button and get a message it has not been sent’ for further information.

When the device is switched on by pressing the Start button, the battery levels are indicated in the top right hand corner of the screen. If this indicates battery levels of 1 or 2 bars, the batteries will need replacing. Please contact the trial team who will arrange to send you replacement batteries and talk you through replacing them.

I can't get the ECG device to work, what should I do, and how do I get help?

You can find instructions for using the recorder here which should answer most questions. If the ECG device does not register the contact with your thumbs / index fingers and does not start recording, please see the relevant FAQ above (The ECG device does not always immediately register my thumbs / fingers and start the recording. Why is this and how do I get it to work?).

Many other issues (for example problems with the SIM or SD card) are likely to be temporary and clear by themselves. If the ECG device is not switching off, you can perform a reset by pressing the three buttons (START, SYMPTOM, SEND) simultaneously. If this does not work, or you would like to contact us, click here for contact details for the Cambridge research team and we will be happy to help.

Does exercising immediately prior to recording an ECG affect the trace?

When recording an ECG it is best to be relaxed and sitting down. If you have just exercised vigorously it is advisable to take a few minutes to relax before you start to record an ECG.

I am part of the trial and have been invited to take part in screening. However I have changed my GP practice. Can I still take part in screening?

If you are no longer registered at the GP practice that originally invited you to take part in the trial, unfortunately we will not be able to proceed with screening. This is because we need your original GP practice (who are trained to deliver the trial) to manage your screening result and ensure you are followed up appropriately (if necessary). However you are still a participant in the trial, even if you do not take part in screening.

How do I return the ECG device?

At the end of the 3 week screening period you will need to return the device using the Freepost return padded envelope provided. Please check the device before returning it, and (if applicable) try to send any ‘unsent’ ECG recordings. Please return:

  1. ECG device
  2. Zenicor User Instructions
  3. Black device case

Put these items in the Freepost return padded envelope provided and securely seal the envelope. Post the Freepost return envelope in any post box. No stamps are needed and there is no need to take it to the post office. Please do not take it to your GP practice.

How do you know it is my ECG device when I return it?

Each device has a unique serial number and is registered to a particular participant. When the device is returned, any unsent ECGs are uploaded to the system. The device is then disconnected from that participant before cleaning and preparing it for allocation to another participant. There is no need to include your name or other details when returning the device.

When and how do I get my screening results?

The ECG traces will be analysed once the device has been returned to the trial team. No ECGs will be reviewed before this time. The screening result will usually be available within 12 weeks of the date the device is received back by the trial team. Your GP practice will inform you of your screening result (whether positive or negative), and whether any action is required.


We are already screening for AF in our practice. Can we still take part in the SAFER trial?

Yes, you can take part in the trial regardless of what other AF detection initiatives you may be using (such as the AHSN initiative, or doing pulse checks). If you take part in the trial you will be free to continue with, or start, other AF detection initiatives. If you have any specific questions please get in touch with us.

Our practice has completed the AMALFI Study. Can we still take part in the SAFER trial?

Due to the overlap of the two trials you cannot run the SAFER trial if you have completed AMALFI. The CRN are managing this on a regional basis. If you have any specific questions please get in touch with us.

Our practice has completed the DaRe2THINK Study. Can we still take part in the SAFER trial?

Yes, you can still take part in the SAFER trial. We will ask you to exclude any patients consented to the DaRe2THINK Study from receiving an invitation to the SAFER Trial. If after completing the SAFER Trial you wish to take part in the DaRe2THINK Study, you will need to exclude patients consented to the SAFER Trial from receiving an invitation to the DaRe2THINK Study. We would ask that you do not undertake both studies at the same time. If you have any specific questions please get in touch with us.