Automated blood pressure measurement in atrial fibrillation

Stergiou, George S.; Destounis, Antonios; Tzamouranis, D

doi:10.1097/hjh.0b013e32835ae9b3

Cited by 16 publications

(9 citation statements)

References 8 publications

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“…Arrhythmias, predominantly atrial fibrillation, were a frequent cause of failure. This is a recognized problem with automated sphygmomanometers (7,18), and interarm difference studies often therefore list atrial fibrillation as an exclusion criterion, whereas the DARE protocol does not exclude subjects with arrhythmias; however, an adequate sample size was still achieved.…”

Section: Strengths and Limitations Of Studymentioning

confidence: 99%

Interarm Blood Pressure Difference in People With Diabetes: Measurement and Vascular and Mortality Implications

et al. 2014

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OBJECTIVEDifferences in blood pressure between arms are associated with vascular disease and increased mortality; this has not been reported in diabetes. We explored these associations, and assessed reference standard and pragmatic measurement techniques, in people with diabetes and in nondiabetic controls. RESEARCH DESIGN AND METHODSA prospective cohort study in Devon, England, recruited 727 people with type 1 or type 2 diabetes and 285 nondiabetic controls. Simultaneous repeated measurements of bilateral blood pressure were made at recruitment. Data were used to inform a pragmatic measurement strategy. Interarm differences were examined for cross-sectional associations with target organ disease and prospective mortality associations (median follow-up 52 months). RESULTSWe found 8.6% of participants with diabetes and 2.9% of controls had systolic interarm differences ‡10 mmHg. Single pairs of blood pressure measurements had high negative predictive values (97-99%) for excluding interarm differences. Systolic interarm differences ‡10 mmHg in diabetes were associated with peripheral arterial disease (odds ratio [OR] 3.4 [95% CI 1.2-9.3]). Differences ‡15 mmHg were associated with diabetic retinopathy .6]) and chronic kidney disease ). Systolic interarm differences were associated prospectively with increased cardiovascular mortality: hazard ratios 3.5 (1.0-13.0) for ‡10 mmHg and 9.0 (2.0-41.0) for ‡15 mmHg. CONCLUSIONSBlood pressure should be measured in both arms during initial assessment in diabetes. Systolic interarm differences can be excluded with a single pair of measurements. In the population with diabetes, systolic differences may be associated with an increased risk of morbidity and mortality.

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Section: Strengths and Limitations Of Studymentioning

confidence: 99%

Interarm Blood Pressure Difference in People With Diabetes: Measurement and Vascular and Mortality Implications

et al. 2014

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“…[6][7][8] A recent meta-analysis indicated that oscillometric measurements can detect systolic, but not diastolic, pressure in a sufficiently accurate manner compared with auscultatory sphygmomanometry. 9 However, in all previous reports, sphygmomanometry was used as reference technique. It has to be kept in mind that AF impedes sphygmomanometry as well because variations in stroke volume cause beat-to-beat differences in pulse pressure that in turn influence Korotkoff sounds.…”

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confidence: 99%

Impact of Atrial Fibrillation on the Accuracy of Oscillometric Blood Pressure Monitoring

Pagonas

Schmidt²,

Eysel³

et al. 2013

Hypertension

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Abstract-The introduction of automated oscillometric blood pressure monitors was the basis for today's widespread use of blood pressure self-measurement. However, in atrial fibrillation, there is a controversial debate on the use of oscillometry because there is a high variability of heart rate and stroke volume. To date, the accuracy of oscillometric blood pressure monitoring in atrial fibrillation has only been investigated using auscultatory sphygmomanometry as reference method, which may be biased by arrhythmia as well. We performed a cross-sectional study in 102 patients (52 sinus rhythm, 50 atrial fibrillation) assessing the accuracy of an automated and validated oscillometric upper arm (M5 Professional, Omron) and wrist device (R5 Professional, Omron) to invasively assessed arterial pressure. Blood pressure values were calculated as the mean of 3 consecutive measurements. Systolic and diastolic blood pressure did not significantly differ in patients with sinus rhythm and atrial fibrillation, independent of the method of measurement (P>0.05 each). The within-subject variability of the oscillometric measurements was higher in patients with atrial fibrillation compared with sinus rhythm (P<0.01 each). The biases of systolic and diastolic blood pressure, however, did not significantly differ in presence or absence of atrial fibrillation in Bland-Altmann analysis (P>0.05 each). In conclusion, atrial fibrillation did not significantly affect the accuracy of oscillometric measurements, if 3 repeated measurements were performed. (Hypertension. 2013;62:579-584.)

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“…The measurements were transferred to a computer for analysis. The monitoring was repeated as necessary until ≥70% of the day and night values measured were satisfactory [16].…”

Section: Twenty-four-hour Abpmmentioning

confidence: 99%

Predictors for atrial fibrillation onset in CKD patients with pacemaker

Kiuchi¹,

Chen²

2017

Nephrol Renal Dis

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Aim: To assess the hypothesis that chronic kidney disease (CKD) may affect the incidence of AF, the present study investigated the influence of renal impairment and CKD on the new onset of AF in this population. Methods:A cohort of inividuals received standard therapy for treatment of sinus node disease (SND), and second-or third-degree atrioventricular block (AVB), DDDR pacemaker implantation. The maximum follow-up period was 6 years after the implantation procedure.Results: CKD, age, hypertension, smoking, left ventricular mass index (LVMI), left atrial diameter (LAD), and pacemakers implanted due to 2 nd or 3 rd degree AVB were significantly different (defined as P<0.1) between the no CKD and CKD population in the univariate Cox logistic regression model. All of them except hypertension were significant (P<0.05) in the multivariate Cox logistic regression model. Independent predictors of AF incidence were re-examined by stepwise regression analysis including all clinical and echocardiographic variables as possible independent factors. The presence of CKD as well as age, smoking, LVMI, LAD, and AVB was an independent predictor of new-onset AF (age, hazard ratio (HR): 1.031, 95% confidence interval (CI): 1.023 -1.038, P<0.0001; smoking, HR: 1.315, 95%CI: 1.110 -1.558, P=0.0020; LVMI, HR:1.017, 95%CI: 1.013 -1.020, P=0.0020; LAD, HR: 1.281, 95%CI: 1.241 -1.322, P<0.0001; AVB, HR: 1.240, 95%CI: 1.087 -1.415, P=0.0010; and CKD, HR: 2.073, 95% CI: 1.616 -2.660, P<0.0001). The association of CKD stages with the incidence of AF was lastly evaluated by the univariate Cox analysis, the occurrence of new-onset AF was significantly increased in the participant groups with CKD stage 3, 4 and 5 before and after adjustment for confounding factors, being significantly associated with the increased incidence of AF. Conclusions:The present study demonstrated that CKD was associated with an increased risk of new onset AF in patients with pacemakers and that the impact of CKD on the incidence of AF was independent of LV hypertrophy and LA dilatation. In particular, moderate to later stages of CKD were strongly related to the increasing occurrence of AF.

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Automated blood pressure measurement in atrial fibrillation

Cited by 16 publications

References 8 publications

Interarm Blood Pressure Difference in People With Diabetes: Measurement and Vascular and Mortality Implications

Interarm Blood Pressure Difference in People With Diabetes: Measurement and Vascular and Mortality Implications

Impact of Atrial Fibrillation on the Accuracy of Oscillometric Blood Pressure Monitoring

Predictors for atrial fibrillation onset in CKD patients with pacemaker

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