Newer technologies for detection of atrial fibrillation

Zungsontiporn, Nath; Link, Mark S.

doi:10.1136/bmj.k3946

Cited by 44 publications

(57 citation statements)

References 123 publications

(173 reference statements)

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“…However, arrhythmia affects mainly elderly and arrhythmia is seldom present at the time of hospital visit. Hence, there is a need to validate and compare methods for AF screening in an ambulatory setting in the intended population …”

Section: Introductionsupporting

confidence: 82%

“…Using parallel monitoring, no new cases of AF were detected using intermittent ECG monitoring only. Using continuous event recording, AF was detected on average day 4 (IQR: 1-8) compared to day 8 (IQR: [4][5][6][7][8][9][10][11][12][13][14] using intermittent ECG (P = .135). There was a significant difference in AF detection between the two devices already after 3 days of monitoring (P = 0.03; Figure 1 Individuals diagnosed with AF had lower systolic blood pressure compared to those free of AF.…”

Section: Newly Diagnosed Af Per Screening Methodsmentioning

confidence: 99%

“…Hence, there is a need to validate and compare methods for AF screening in an ambulatory setting in the intended population. 13 We aim to compare the yield of AF detection, compliance, and patient-based experience in population screening in elderly individuals, by using intermittent ECG recordings vs continuous event recording.…”

Section: Introductionmentioning

confidence: 99%

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Intermittent vs continuous electrocardiogram event recording for detection of atrial fibrillation—Compliance and ease of use in an ambulatory elderly population

Fredriksson

Gudmundsdottir

Frykman

et al. 2020

Clinical Cardiology

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Background There are many atrial fibrillation (AF) screening devices available. Validation studies have mainly been performed in optimal settings in the young population. Hypothesis We aim to compare the yield of AF detection, compliance, and patient‐based experience in an ambulatory elderly population by using intermittent electrocardiogram (ECG) recordings and continuous event recording simultaneously. Methods The study participants were part of the STROKESTOP II study, a Swedish screening study for AF. All participants were 75/76 years of age, were clinically free of AF, and had N‐terminal pro b‐type natriuretic peptides levels ≥125 ng/L. AF screening was performed in parallel during a 2‐week period, using a continuous event recording device (R‐test 4; Novacor) and 30‐second intermittent recordings using a handheld ECG device (Zenicor II) four times daily. Participants were asked to fill out a questionnaire with regard to compliance and ease of use of the devices. Results During continuous event recording, 6% (n = 15/269) were diagnosed with AF and intermittent ECG detected AF in 2% (n = 5/269) of the participants (P = .002). No new cases of AF were detected using intermittent ECG monitoring only, but some episodes were detected in parallel for patients. On a graded ordinal scale of 1 to 5, with 1 reflecting “very easy to use”, continuous monitoring was graded 2 (interquartile range [IQR]: 1‐3) compared to intermittent 1 (IQR: 1‐1) (P < .001). Conclusion Continuous event recording detected three times more AF compared to intermittent ECG in an elderly ambulatory population. Compliance and user‐friendliness were rated higher for the intermittent ECG device.

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Section: Introductionsupporting

confidence: 82%

Section: Newly Diagnosed Af Per Screening Methodsmentioning

confidence: 99%

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Intermittent vs continuous electrocardiogram event recording for detection of atrial fibrillation—Compliance and ease of use in an ambulatory elderly population

Fredriksson

Gudmundsdottir

Frykman

et al. 2020

Clinical Cardiology

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“…Several methods are available for the detection of asymptomatic AF: pulse palpitation, standalone ECG recording devices, smartphone‐based ECG recording devices, smartphone‐based PPG, and BP monitors with an AF detection algorithm . Our device is similar to the smartphone‐based PPG and BP monitor with an AF detection algorithm.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of an algorithm for detecting atrial fibrillation in a wrist‐type pulse wave monitor

Kabutoya

Takahashi²,

Watanabe

et al. 2019

J of Clinical Hypertension

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We evaluated the diagnostic value of atrial fibrillation (AF) measured by a wrist-type pulse wave monitor in this case-control study. Six serial pulse wave values (three in the left and three in the right wrist) were measured using a wrist-type monitor in 29 AF patients and 30 subjects with sinus rhythm. We defined "monitor AF in irregular pulse peak (IPP) 15/20/25" as follows: (a) IPP: |interval of pulse peak − the average of the interval of the pulse peak| ≥ the average of the interval of the pulse peak × 15/20/25%; (b) irregular heartbeat (IHB): beats of IPP ≥ total pulse × 20%; and (c) monitor AF: ≥4 IHBs of the six pulse wave measurements. In IPP 15, the sensitivity and specificity were 0.97 and 1.00, respectively. Pulse wave analysis by a wrist-type monitor was shown to have high sensitivity and specificity for the diagnosis of AF.

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“…Whilst there have been further papers on the cost-effectiveness of screening in AF, unfortunately several of these have continued to rely on the data from the SAFE trial [24]. An ongoing major issue is that few studies have been able to prove better health outcomes from those asymptomatic adults that were screened [25,26]. This is at least partially due to the difficulty in proving an intervention has prevented a stroke.…”

Section: Screeningmentioning

confidence: 99%

Screening for Atrial Fibrillation and the Role of Digital Health Technologies

Richardson¹,

Hall²,

Mitchell³

2020

Epidemiology and Treatment of Atrial Fibrillation

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Atrial fibrillation is the commonest clinical arrhythmia and a leading cause of hospital admission, morbidity and mortality. New digital health technologies are now allowing patients and the general population to identify heart rhythm abnormalities before any encounter with a medical professional. This chapter will include an overview of the prevalence of atrial fibrillation and explore the current recommendations on methods for arrhythmia screening. We discuss different risk factors as well as physiological and structural markers for atrial fibrillation onset. We explore in detail the application of novel digital health technologies such as wearables, watches and mobile devices which may have an impact on screening detection rates. The article concludes with a discussion about how to manage patients with screen detected atrial fibrillation.

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Newer technologies for detection of atrial fibrillation

Cited by 44 publications

References 123 publications

Intermittent vs continuous electrocardiogram event recording for detection of atrial fibrillation—Compliance and ease of use in an ambulatory elderly population

Intermittent vs continuous electrocardiogram event recording for detection of atrial fibrillation—Compliance and ease of use in an ambulatory elderly population

Diagnostic accuracy of an algorithm for detecting atrial fibrillation in a wrist‐type pulse wave monitor

Screening for Atrial Fibrillation and the Role of Digital Health Technologies

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