Actively Recruiting
The Rhythm Evaluation for AntiCoagulaTion With Continuous Monitoring of Atrial Fibrillation
Led by Johns Hopkins University · Updated on 2026-04-09
5350
Participants Needed
93
Research Sites
315 weeks
Total Duration
On this page
Sponsors
J
Johns Hopkins University
Lead Sponsor
N
National Heart, Lung, and Blood Institute (NHLBI)
Collaborating Sponsor
AI-Summary
What this Trial Is About
REACT-AF is a multicenter prospective, randomized, open-label, blinded endpoint (PROBE design), controlled trial comparing the current Standard Of Care (SOC) of continuous Direct Oral Anticoagulation (DOAC) use versus time-delimited (1 month) DOAC guided by an AF-sensing Smart Watch (AFSW) in participants with a history of paroxysmal or persistent Atrial Fibrillation (AF) and low-to-moderate stroke risk.
CONDITIONS
Official Title
The Rhythm Evaluation for AntiCoagulaTion With Continuous Monitoring of Atrial Fibrillation
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Age between 22 and 85 years
- English-speaking participants (Spanish-only speakers may be included in future at select sites)
- History of non-permanent (paroxysmal or persistent) atrial fibrillation
- CHA2DS2-VASc score 1-4 for men and 2-4 for women without prior stroke or transient ischemic attack
- Currently taking a direct oral anticoagulant (DOAC) and willing to continue for the study duration
- Able to comply with the protocol including owning a compatible smartphone, willingness to wear the smartwatch at least 14 hours daily, and being within cellular service range most of the time
- Willing and able to discontinue DOAC as needed
- Able and willing to provide informed consent
You will not qualify if you...
- Permanent or valvular atrial fibrillation
- Current treatment with warfarin and unable or unwilling to take DOAC
- Pregnant or nursing women
- Chronic use of aspirin, other antiplatelet agents, or NSAIDs outside guidelines and unwilling or unable to stop during study
- Existing cardiac rhythm device or need for pacemaker, defibrillator, or cardiac resynchronization device or planned insertable monitor used to guide anticoagulation
- Known or suspected AF lasting 1 hour or more per month over past 3 months
- Recent AF episodes lasting 1 hour or more on monitoring within 45 days before randomization
- AF ablation within last 2 months
- Prior or planned left atrial appendage occlusion or ligation
- Mechanical heart valve or severe valve disease
- Hypertrophic cardiomyopathy
- Need for DOAC for reasons other than AF-related stroke prevention
- High risk for non-cardioembolic stroke (e.g., severe carotid artery disease)
- Participation in another drug or device study within 30 days or planned during this trial without approval
- Tattoos, birthmarks, or scars on the wrist where the smartwatch would be worn
- Tremor on the wrist side where the smartwatch would be worn
- Any condition deemed unsafe for study participation by the investigator
- Known allergy or contraindication to DOACs
- Prior stroke or transient ischemic attack
- Reversible AF causes like cardiac surgery or untreated hyperthyroidism
- More than 5% premature atrial or ventricular beats on monitoring before enrollment
- Untreated atrial flutter
- Stage 4 or 5 chronic kidney disease
- Conditions increasing bleeding risk such as recent major surgery, planned surgery needing anticoagulation stop, history of serious bleeding, recent ulcers, bleeding disorders, uncontrolled high blood pressure
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Trial Site Locations
Total: 93 locations
1
Banner University
Phoenix, Arizona, United States, 85006
Actively Recruiting
2
University of Southern California - Keck School of Medicine
Los Angeles, California, United States, 90033
Actively Recruiting
3
University of California Los Angeles (UCLA Health)
Los Angeles, California, United States, 90095
Actively Recruiting
4
UC Davis Health
Sacramento, California, United States, 95817
Actively Recruiting
5
Scripps Health
San Diego, California, United States, 92103
Actively Recruiting
6
Kaiser Permanente
San Francisco, California, United States, 94115
Not Yet Recruiting
7
Stanford University
Stanford, California, United States, 94305
Actively Recruiting
8
University of Colorado
Aurora, Colorado, United States, 80045
Actively Recruiting
9
South Denver Cardiology Associates, P.C.
Littleton, Colorado, United States, 80120
Actively Recruiting
10
St. Elizabeth's Medical Center
Washington D.C., District of Columbia, United States, 20032
Actively Recruiting
11
Medical Faculty Associates George Washington University
Washington D.C., District of Columbia, United States, 20037
Withdrawn
12
BayCare Health Systems
Clearwater, Florida, United States, 33759
Actively Recruiting
13
University of Florida
Gainesville, Florida, United States, 32611
Actively Recruiting
14
Mayo Clinic
Jacksonville, Florida, United States, 32224
Actively Recruiting
15
University of Miami - Leonard S. Miller SOM
Miami, Florida, United States, 33136
Actively Recruiting
16
Sarasota Memorial Health Care System
Sarasota, Florida, United States, 34236
Actively Recruiting
17
Cleveland Clinic Florida
Stuart, Florida, United States, 34994
Withdrawn
18
Baycare Health Systems Clearwater
Winter Haven, Florida, United States, 33881
Actively Recruiting
19
Emory University
Atlanta, Georgia, United States, 30332
Actively Recruiting
20
Georgia Arrhythmia Consultants and Research Institute
Warner Robins, Georgia, United States, 31093
Actively Recruiting
21
University of Illinois Chicago
Chicago, Illinois, United States, 60607
Actively Recruiting
22
Northwestern University
Chicago, Illinois, United States, 60611
Actively Recruiting
23
Rush University Medical Center
Chicago, Illinois, United States, 60612
Actively Recruiting
24
University of Chicago
Chicago, Illinois, United States, 60637
Actively Recruiting
25
Loyola University Chicago
Chicago, Illinois, United States, 60660
Actively Recruiting
26
Alexian Brothers Health System
Elk Grove Village, Illinois, United States, 60007
Actively Recruiting
27
NorthShore University HealthSystem
Evanston, Illinois, United States, 60201
Actively Recruiting
28
Midwest Cardiovascular Institute
Naperville, Illinois, United States, 60540
Actively Recruiting
29
Ascension St. Vincent
Indianapolis, Indiana, United States, 46260
Actively Recruiting
30
University of Iowa Hospitals and Clinics
Iowa City, Iowa, United States, 52242
Actively Recruiting
31
Maine Medical Partners MaineHealth Cardiology
Scarborough, Maine, United States, 04074
Actively Recruiting
32
Johns Hopkins Univeristy
Baltimore, Maryland, United States, 21218
Actively Recruiting
33
Tufts Medical Center
Boston, Massachusetts, United States, 02111
Actively Recruiting
34
Mass General Hospital
Boston, Massachusetts, United States, 02114
Not Yet Recruiting
35
Brigham and Women's Hospital
Boston, Massachusetts, United States, 02115
Actively Recruiting
36
Boston Medical Center
Boston, Massachusetts, United States, 02118
Actively Recruiting
37
BMC - Brighton
Boston, Massachusetts, United States, 02135
Actively Recruiting
38
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States, 02215
Actively Recruiting
39
Lahey Hospital & Medical Center
Burlington, Massachusetts, United States, 01805
Actively Recruiting
40
UMass Chan Medical School
Worcester, Massachusetts, United States, 01655
Active, Not Recruiting
41
Henry Ford Health
Detroit, Michigan, United States, 48202
Actively Recruiting
42
Corewell Health (Former Spectrum Health)
Grand Rapids, Michigan, United States, 49503
Actively Recruiting
43
Trinity Health Grand Rapids/Mercy Health
Grand Rapids, Michigan, United States, 49503
Actively Recruiting
44
William Beaumont Hospital
Royal Oak, Michigan, United States, 48073
Actively Recruiting
45
Trinity Health Michigan Heart - Ann Arbor
Ypsilanti, Michigan, United States, 48197
Actively Recruiting
46
Essentia Health The Duluth Clinic
Duluth, Minnesota, United States, 55812
Active, Not Recruiting
47
Minneapolis Heart Institute Foundation
Minneapolis, Minnesota, United States, 55407
Actively Recruiting
48
Hennepin Healthcare Research Institute
Minneapolis, Minnesota, United States, 55415
Actively Recruiting
49
University of Minnesota
Minneapolis, Minnesota, United States, 55455
Actively Recruiting
50
University Health Truman Medical Center
Kansas City, Missouri, United States, 64108
Withdrawn
51
Washington University School of Medicine
St Louis, Missouri, United States, 63110
Actively Recruiting
52
Advanced Heart and Vascular Institute of Hunterdon
Flemington, New Jersey, United States, 08822
Actively Recruiting
53
Hackensack Meridian Health
Hackensack, New Jersey, United States, 07601
Actively Recruiting
54
Rutgers, the State University of New Jersey
Piscataway, New Jersey, United States, 08854
Actively Recruiting
55
The Valley Hospital, Inc.
Ridgewood, New Jersey, United States, 07450
Actively Recruiting
56
University of New Mexico Health Sciences Center
Albuquerque, New Mexico, United States, 87102
Actively Recruiting
57
Presbyterian Healthcare Services
Albuquerque, New Mexico, United States, 87106
Active, Not Recruiting
58
University at Buffalo
Buffalo, New York, United States, 14214
Actively Recruiting
59
NYU Langone Health
New York, New York, United States, 10016
Actively Recruiting
60
Columbia University Medical Center
New York, New York, United States, 10032
Actively Recruiting
61
Weill Medical College of Cornell University
New York, New York, United States, 10065
Actively Recruiting
62
NewYork Presbyterian - Queens
Queens, New York, United States, 11355
Actively Recruiting
63
Staten Island University Hospital-Northwell Health
Staten Island, New York, United States, 10305
Actively Recruiting
64
Stony Brook University
Stony Brook, New York, United States, 11794
Actively Recruiting
65
Westchester Medical Center
Valhalla, New York, United States, 10595
Actively Recruiting
66
White Plains Hospital
White Plains, New York, United States, 10601
Actively Recruiting
67
University of North Carolina
Chapel Hill, North Carolina, United States, 27599
Actively Recruiting
68
Wake Forest Baptist Health
Winston-Salem, North Carolina, United States, 27157
Actively Recruiting
69
The Lindner Center for Research and Education at The Christ Hospital
Cincinnati, Ohio, United States, 45219
Actively Recruiting
70
University of Cincinnati College of Medicine
Cincinnati, Ohio, United States, 45267
Actively Recruiting
71
Ohio State University Medical Center
Columbus, Ohio, United States, 43210
Actively Recruiting
72
OhioHealth Research Institute
Columbus, Ohio, United States, 43214
Actively Recruiting
73
Wooster Community Hospital
Wooster, Ohio, United States, 44691
Actively Recruiting
74
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, United States, 73104
Actively Recruiting
75
Cardiology Consultants of Philadelphia
Paoli, Pennsylvania, United States, 19301
Not Yet Recruiting
76
Thomas Jefferson University
Philadelphia, Pennsylvania, United States, 19144
Actively Recruiting
77
Allegheny Singer Research Institute
Pittsburgh, Pennsylvania, United States, 15212
Actively Recruiting
78
Penn State Health Medical Group Berks Cardiology
Wyomissing, Pennsylvania, United States, 19610
Actively Recruiting
79
Rhode Island Hospital
Providence, Rhode Island, United States, 02903
Actively Recruiting
80
Medical University of South Carolina
Charleston, South Carolina, United States, 29425
Actively Recruiting
81
MUSC Health Heart and Vascular
Columbia, South Carolina, United States, 29204
Actively Recruiting
82
Texas Cardiac Arrhythmia Research Foundation
Austin, Texas, United States, 78705
Actively Recruiting
83
University of Texas Southwestern Medical Center
Dallas, Texas, United States, 75390
Actively Recruiting
84
Baylor College of Medicine
Houston, Texas, United States, 77030
Actively Recruiting
85
Houston Methodist Hospital
Houston, Texas, United States, 77030
Actively Recruiting
86
University of Texas Health Science Center at Houston
Houston, Texas, United States, 77030
Actively Recruiting
87
University of Utah
Salt Lake City, Utah, United States, 84112
Actively Recruiting
88
University of Virginia
Charlottesville, Virginia, United States, 22903
Actively Recruiting
89
James River Cardiology
Richmond, Virginia, United States, 23229
Actively Recruiting
90
Virginia Commonwealth University
Richmond, Virginia, United States, 23284
Actively Recruiting
91
St. Joseph Medical Center Tacoma
Tacoma, Washington, United States, 98405
Actively Recruiting
92
University of Wisconsin
Madison, Wisconsin, United States, 53706
Actively Recruiting
93
Medical College of Wisconsin Froedtert Hospital
Milwaukee, Wisconsin, United States, 53226
Actively Recruiting
Research Team
S
Shea Smith
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
SINGLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
PREVENTION
Number of Arms
2
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