Accuracy and feasibility of portable blood pressure monitoring in the detection of atrial fibrillation in hemodialysis patients

AlAwwa, Izzat; Saleh, Akram; Wahbeh, Ayman; Jallad, Shatha; Ibrahim, Sarah; Al-Awwa, Ahmad; Farah, Randa

doi:10.31083/j.rcm.2021.01.802

Cited by 2 publications

(7 citation statements)

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“…Among 3096 articles initially retrieved, 21 DTA reports including 23 DTA studies fulfilled the inclusion criteria and were included in the systematic review and meta-analysis. 17–37 Two reports included 2 studies each. 31,34 The main characteristics of the included studies are summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…The AF detection accuracy was assessed using office, home, and ambulatory devices in 2, 22,25 18, 17,18,20,21,23,26,28–37 and 3 studies, 19,24,27 respectively. Ten studies were conducted in Europe, 20,22,24,27,28,30,32,34,36 8 in Asia, 17–19,21,23,25,26,29 and the rest 5 in the United States. 31,33,35,37 Twelve studies used Microlife BP measuring devices, 22,23,28–36 6 used Omron devices 20,21,25,31,34,37 (1 study with an AF detector implemented by the investigators on an Omron device 37 ), and 2 used A&D devices.…”

Section: Resultsmentioning

confidence: 99%

“…One study included patients on hemodialysis. 21 The PRISMA 2020 Checklists (including the checklist for abstracts) for the present systematic review and meta-analysis are presented in Tables S2 and S3. The respective 2020 PRISMA flow diagram is presented in Figure S1.…”

Section: Resultsmentioning

confidence: 99%

“…31,34 The main characteristics of the included studies are summarized in Table 1. The AF detection accuracy was assessed using office, home, and ambulatory devices in 2, 22,25 18, 17,18,20,21,23,26,[28][29][30][31][32][33][34][35][36][37] and 3 studies, 19,24,27 respectively. Ten studies were conducted in Europe, 20,22,24,27,28,30,32,34,36 8 in Asia, [17][18][19]21,23,25,26,29 and the rest 5 in the United States.…”

Section: Literature Search and Study Inclusionmentioning

confidence: 99%

“…The AF detection accuracy was assessed using office, home, and ambulatory devices in 2, 22,25 18, 17,18,20,21,23,26,[28][29][30][31][32][33][34][35][36][37] and 3 studies, 19,24,27 respectively. Ten studies were conducted in Europe, 20,22,24,27,28,30,32,34,36 8 in Asia, [17][18][19]21,23,25,26,29 and the rest 5 in the United States. 31,33,35,37 Twelve studies used Microlife BP measuring devices, 22,23,[28][29][30][31][32][33][34][35]…”

Section: Literature Search and Study Inclusionmentioning

confidence: 99%

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Atrial Fibrillation Screening During Routine Automated Office, Home, and Ambulatory Blood Pressure Measurement: A Diagnostic Test Accuracy Systematic Review and Meta-Analysis

Kyriakoulis,

Kollias,

Menti

et al. 2024

Hypertension

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BACKGROUND: Atrial fibrillation (AF) is often asymptomatic and undiagnosed. As AF and hypertension often coexist, opportunistic AF detection during routine automated blood pressure (BP) measurement appears to be an attractive screening method. METHODS: A systematic literature search was conducted to identify studies assessing the diagnostic test accuracy of office, home, or 24-hour ambulatory BP measuring devices with AF detection algorithms versus reference electrocardiography. Analyses were performed per participant (AF status based on several BP readings; most office/home devices) or per reading (AF status based on individual readings; all ambulatory devices). A meta-analysis stratified by device type (office/home/ambulatory) was conducted to calculate pooled measures of diagnostic accuracy. Sensitivity/meta-regression analyses were also performed. RESULTS: Among 3096 records initially retrieved, 23 diagnostic test accuracy studies were included. Data derived from 11 093 individuals (weighted age 69 years, males 56%, hypertensives 79%, diabetics 24%, and AF prevalence 17%) indicated a pooled sensitivity 0.97 (95% CI, 0.92–0.99), specificity 0.93 (95% CI, 0.90–0.95), and accuracy 0.93 (95% CI, 0.89–0.95), with generally consistent results using office, home, or ambulatory BP devices (slightly lower specificity with the latter). The positive and negative predictive values were 0.70 (95% CI, 0.60–0.80) and 0.99 (95% CI, 0.98–1.00), respectively. Sensitivity analyses indicated lower specificity in studies implementing reading versus participant analyses. Most studies presented a low risk of bias and minor applicability concerns. CONCLUSIONS: There is considerable and consistent evidence suggesting high diagnostic accuracy of AF detection algorithms implemented in automated BP monitors during routine BP measurements in and out of the office. AF diagnosis requires verification (electrocardiography) before treatment is administered.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Literature Search and Study Inclusionmentioning

confidence: 99%

Section: Literature Search and Study Inclusionmentioning

confidence: 99%

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Atrial Fibrillation Screening During Routine Automated Office, Home, and Ambulatory Blood Pressure Measurement: A Diagnostic Test Accuracy Systematic Review and Meta-Analysis

Kyriakoulis,

Kollias,

Menti

et al. 2024

Hypertension

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Sensitivity and specificity of automated blood pressure devices to detect atrial fibrillation: A systematic review and meta-analysis of diagnostic accuracy

Tang

Yip

et al. 2022

Front. Cardiovasc. Med.

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BackgroundAtrial fibrillation (AF) is a prevalent and preventable cause of stroke and mortality.AimThis systematic review and meta-analysis aimed to investigate the sensitivity and specificity of office and out-of-office automated blood pressure (BP) devices to detect AF.MethodsDiagnostic studies, extracted from databases such as Ovid Medline and Embase, on AF detection by BP device(s), electrocardiography, and reported sensitivity and specificity, were included. Screening of abstracts and full texts, data extraction, and quality assessment were conducted independently by two investigators using Covidence software. The sensitivity and specificity of the BP devices were pooled using a random-effects model.ResultsSixteen studies including 10,158 participants were included. Only a few studies were conducted in primary care (n = 3) or with a low risk of bias (n = 5). Office BP devices, which utilised different algorithms to detect AF, had a sensitivity and specificity of 96.2 and 94%, respectively. Specificity was reduced when only one positive result was considered among consecutive BP measurements. Only a few studies (n = 3) investigated out-of-office BP. Only one study (n = 100) suggested the use of ≥79 and ≥26% of positive readings on 24-h ambulatory BP measurements to detect AF and paroxysmal AF, respectively.ConclusionsOffice BP devices can be used clinically to screen for AF in high-risk populations. Clinical trials are needed to determine the effect of AF screening using office BP devices in reducing stroke risk and mortality. Further studies are also required to guide out-of-office use of BP devices for detecting paroxysmal AF or AF.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022319541, PROSPERO CRD42022319541.

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Accuracy and feasibility of portable blood pressure monitoring in the detection of atrial fibrillation in hemodialysis patients

Cited by 2 publications

References 0 publications

Atrial Fibrillation Screening During Routine Automated Office, Home, and Ambulatory Blood Pressure Measurement: A Diagnostic Test Accuracy Systematic Review and Meta-Analysis

Atrial Fibrillation Screening During Routine Automated Office, Home, and Ambulatory Blood Pressure Measurement: A Diagnostic Test Accuracy Systematic Review and Meta-Analysis

Sensitivity and specificity of automated blood pressure devices to detect atrial fibrillation: A systematic review and meta-analysis of diagnostic accuracy

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