Blood pressure measurement in atrial fibrillation

Stergiou, George S.; Kyriakoulis, Konstantinos G; Stambolliu, Emelina; Destounis, Antonios; Karpettas, Nikos; Kalogeropoulos, Petros

doi:10.1097/hjh.0000000000002201

Cited by 30 publications

(37 citation statements)

References 71 publications

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“…It has been shown that both oscillometric and automated blood pressure measurements were accurate and reliable in patients with NVAF. 14,17,18 Recent data from the RELY study showed that achievement of blood pressure control was related to clinical outcomes, 19 whereby the lowest event rates for death, ischemic stroke, and bleeding were achieved at an SBP of 120-140 mmHg. The event rates of patients with an achieved SBP greater than 140 or lower than 120 mmHg were greater than in those with an achieved SBP of 120-140 mmHg.…”

Section: Discussionmentioning

confidence: 99%

Average Systolic Blood Pressure and Clinical Outcomes in Patients with Atrial Fibrillation: Prospective Data from COOL-AF Registry

Krittayaphong

Pumprueg

Ratanasumawong

et al. 2021

CIA

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Purpose: Hypertension is associated with incident atrial fibrillation (AF) and AF-related complications. We investigated the associations between average systolic blood pressure (SBP) and outcomes in a nationwide cohort of Asian patients with non-valvular atrial fibrillation (NVAF). Patients and Methods: A multicenter nationwide registry of patients with NVAF in Thailand was conducted during 2014-2017. Clinical data, including blood pressure, were recorded at baseline and then every 6 months. Average SBP was calculated from the average of SBP from every visit. Cox regression models were used to calculate the rate of clinical outcomes of interest, ie ischemic stroke or transient ischemic attack (TIA), intracerebral hemorrhage (ICH), and all-cause death. Average SBP was categorized into three groups: <120, 120-140, and ≥140 mmHg. Results: A total of 3402 patients were included, and the mean age was 67.4±11.3 years. The mean (±SD) baseline and average SBPs were 128.5±18.5 and 128.0±13.4 mmHg, respectively. The mean follow-up duration was 25.7±10.6 months. The median rate of ischemic stroke/TIA, ICH, and all-cause death was 1.43 (1.17-1.74), 0.70 (0.52-0.92), and 3.77 (3.33-4.24) per 100 person-years, respectively. The rate of ischemic stroke/TIA and ICH was lowest in patients with average SBP <120 mmHg, and highest among those with average SBP ≥140 mmHg. The death rates were consistent with a J-curve effect, being lowest in patients with an average SBP 120-140 mmHg. Sustained SBP control is more important than the SBP from a single visit. Conclusion: Sustained control of SBP was significantly associated with a reduction in adverse clinical outcomes in patients with NVAF.

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Section: Discussionmentioning

confidence: 99%

Average Systolic Blood Pressure and Clinical Outcomes in Patients with Atrial Fibrillation: Prospective Data from COOL-AF Registry

Krittayaphong

Pumprueg

Ratanasumawong

et al. 2021

CIA

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“…1,7 Oscillometry-based algorithms that detect AF during automated blood pressure measurement have been shown to have high diagnostic accuracy. 28…”

Section: Technology Usedmentioning

confidence: 99%

“…1,7 Oscillometry-based algorithms that detect AF during automated blood pressure measurement have been shown to have high diagnostic accuracy. 28 Although growing evidence suggests that consumer devices are accurate for AF detection in populations at high risk for the arrhythmia, few studies have evaluated their performance in low-risk populations. Furthermore, no randomized studies have shown that commercial technology-based AF screening reduces stroke or other AF complications.…”

Section: Technology Usedmentioning

confidence: 99%

Consumer-Led Screening for Atrial Fibrillation: Frontier Review of the AF-SCREEN International Collaboration

et al. 2022

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The technological evolution and widespread availability of wearables and handheld ECG devices capable of screening for atrial fibrillation (AF), and their promotion directly to consumers, has focused attention of health care professionals and patient organizations on consumer-led AF screening. In this Frontiers review, members of the AF-SCREEN International Collaboration provide a critical appraisal of this rapidly evolving field to increase awareness of the complexities and uncertainties surrounding consumer-led AF screening. Although there are numerous commercially available devices directly marketed to consumers for AF monitoring and identification of unrecognized AF, health care professional–led randomized controlled studies using multiple ECG recordings or continuous ECG monitoring to detect AF have failed to demonstrate a significant reduction in stroke. Although it remains uncertain if consumer-led AF screening reduces stroke, it could increase early diagnosis of AF and facilitate an integrated approach, including appropriate anticoagulation, rate or rhythm management, and risk factor modification to reduce complications. Companies marketing AF screening devices should report the accuracy and performance of their products in high- and low-risk populations and avoid claims about clinical outcomes unless improvement is demonstrated in randomized clinical trials. Generally, the diagnostic yield of AF screening increases with the number, duration, and temporal dispersion of screening sessions, but the prognostic importance may be less than for AF detected by single–time point screening, which is largely permanent, persistent, or high-burden paroxysmal AF. Consumer-initiated ECG recordings suggesting possible AF always require confirmation by a health care professional experienced in ECG reading, whereas suspicion of AF on the basis of photoplethysmography must be confirmed with an ECG. Consumer-led AF screening is unlikely to be cost-effective for stroke prevention in the predominantly young, early adopters of this technology. Studies in older people at higher stroke risk are required to demonstrate both effectiveness and cost-effectiveness. The direct interaction between companies and consumers creates new regulatory gaps in relation to data privacy and the registration of consumer apps and devices. Although several barriers for optimal use of consumer-led screening exist, results of large, ongoing trials, powered to detect clinical outcomes, are required before health care professionals should support widespread adoption of consumer-led AF screening.

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“…Трудности, возникающие при измерении АД у пациентов с ФП, хорошо известны и постоянно обсуждаются в современной литературе [13][14][15]. Наименее точными, как известно, считаются автоматические приборы, которые одновременно являются самыми распространенными [16][17][18].…”

Section: обсуждение полученных результатовunclassified

Beat-to-beat blood pressure measurement in patients with atrial fibrillation: a step towards personalized managemen

Викторович¹,

Pivovarov

Зайцев

et al. 2021

Vestnik aritmologii

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Aim. Blood pressure (BP) determination in atrial fibrillation (AF) patients remains challenging due to its high inter-measurement variability. The novel methodology of precise beat-to-beat BP determination may be used to guide the hypotensive therapy selection and adjustment, but along with that provides additional opportunity for the investigation of hemodynamics in patients with chronic AF.Material and method. The study sample consisted of 60 patients with the main diagnosis of grade II-III arterial hypertension; 30 of those were on sinus rhythm and 30 had chronic non-valvular AF. In all patients HR was within the limits recommended for left ventricular ejection fraction of >40%. Beat-to-beat systolic, diastolic, and pulse BP (SBP, DBP, and PBP, respectively) assessment at each heart beat within 15 minute interval was performed with “Kardiotekhnika-SAKR” system (NAO “Incart”, St.Petersburg, Russia).

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Blood pressure measurement in atrial fibrillation

Cited by 30 publications

References 71 publications

Average Systolic Blood Pressure and Clinical Outcomes in Patients with Atrial Fibrillation: Prospective Data from COOL-AF Registry

Average Systolic Blood Pressure and Clinical Outcomes in Patients with Atrial Fibrillation: Prospective Data from COOL-AF Registry

Consumer-Led Screening for Atrial Fibrillation: Frontier Review of the AF-SCREEN International Collaboration

Beat-to-beat blood pressure measurement in patients with atrial fibrillation: a step towards personalized managemen

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