Atrial fibrillation (AF) is the most common cardiac arrhythmia, increasing the risk of stroke, heart failure, and healthcare costs. Although patient self-management can improve outcomes, sustaining long-term engagement is often difficult. Mobile health applications may help address this gap, but their quality and clinical alignment have not been systematically assessed using a validated framework. A structured search of the Apple App Store and Google Play Store identified free, English-language apps supporting AF self-management. Eligible apps included features such as symptom tracking, medication reminders, or educational content. App quality was assessed using the Mobile Application Rating Scale (MARS), which evaluates engagement, functionality, aesthetics, and information quality. Of 455 apps identified, five met all inclusion criteria. Common features included symptom tracking and medication logging, but coverage of evidence-based care domains varied. Mean MARS scores ranged from 4.07 to 4.53 out of 5. Higher-performing apps excelled in functionality and information quality but often lacked comprehensive integration of guideline-recommended care, such as stroke risk assessment or personalized feedback. These findings highlight a gap in high-quality, clinically grounded digital tools for AF self-care. Improved co-design processes and clearer frameworks for app evaluation may help guide the development and selection of effective tools to support AF self-management.

Author summary: We wanted to understand whether smartphone apps can help people manage atrial fibrillation (AF), a common heart rhythm condition that raises the risk of stroke and heart failure. While actively managing AF through lifestyle changes and regular monitoring can reduce health risks, many people find it hard to stay engaged over time. Mobile apps could make self-care more convenient, but their quality and usefulness vary greatly. We searched the two largest app stores for free apps in English that offer tools to help people track symptoms, manage medications, and learn about their condition. Out of more than 450 apps, only five met our criteria. We found that while these apps include helpful features, they often do not cover all aspects of AF care or follow current medical guidelines closely. Our findings show that people with AF have limited trustworthy options to support self-care. We hope our study encourages app developers, healthcare professionals, and patients to work together to create better digital tools that can safely and effectively support people living with AF.