Accuracy of pulsatile photoplethysmography applications or handheld devices vs. 12-lead ECG for atrial fibrillation screening: a systematic review and meta-analysis.

Autor: Sattar Y; Cardiology, West Virginia University, Morgantown, WV, USA., Song D; Cardiology, West Virginia University, Morgantown, WV, USA., Sarvepalli D; Internal Medicine, Guntur Medical College, Guntur, Punjab, India., Zaidi SR; Internal Medicine, Saint Mary Mercy Hospital, Livonia, MI, USA., Ullah W; Cardiology, Thomas Jefferson University, Philadelphia, PA, USA., Arshad J; Internal Medicine, Institute of Medical Sciences, Islamabad, Pakistan., Mir T; Cardiology, Detroit Medical Center Heart Hospital, 311 Mack Ave, Detroit, MI, 48201, USA., Zghouzi M; Cardiology, Detroit Medical Center Heart Hospital, 311 Mack Ave, Detroit, MI, 48201, USA., Elgendy IY; Cardiology, Weill Cornell University, Doha, Qatar., Qureshi W; Cardiology, University of Massachusetts Medical School, Worcester, MA, USA., Chalfoun N; Cardiology, Spectrum Health Heart and Vascular, Michigan State University, Grand Rapids, MI, USA., Alraies M; Cardiology, Detroit Medical Center Heart Hospital, 311 Mack Ave, Detroit, MI, 48201, USA. alraies@hotmail.com.
Jazyk: angličtina
Zdroj: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing [J Interv Card Electrophysiol] 2022 Oct; Vol. 65 (1), pp. 33-44. Date of Electronic Publication: 2021 Nov 13.
DOI: 10.1007/s10840-021-01068-x
Abstrakt: Background: The relative accuracy of pulsatile photoplethysmography applications (PPG) or handheld (HH) devices compared with the gold standard 12-lead electrocardiogram (ECG) for the diagnosis of atrial fibrillation is unknown.
Methods: Digital databases were searched to identify relevant articles. Raw data were pooled using a bivariate model to calculate diagnostic accuracy measures and estimate Hierarchical Summary Receiver Operating Characteristic (HSROC).
Results: A total of 10 articles comprising 4296 patients (mean age 68.9 years, with 56% males) were included in the analysis. Compared with EKG, the pooled sensitivity of PPG and HH devices in AF detection was 0.93 (95% CI 0.87-0.96; p < 0.05) and 0.87 (95% CI. 0.74-0.94; p < 0.05), respectively. The pooled specificity of PPG and HH devices in AF detection was 0.91 (95% CI 0.88-0.94; p < 0.05) and 0.96 (95% CI 0.90-0.98; p < 0.05), respectively. The diagnostic odds ratio was 129 and 144 for PPG and HH devices, respectively. Fagan's nomogram showed the probability of a patient having AF and normal rhythm on PPG or HH devices was 2-3%, while the post-test probability of having AF with an irregular R-R interval on PPG or HH devices was 73% and 82%, respectively. The scatter plot of positive and negative likelihood ratio showed high confirmation of AF and reliability of exclusion of absence of irregular R-R intervals (positive likelihood ratio > 10, and negative likelihood ratio < 0.1) on HH devices while PPG was used as confirmation only.
Conclusions: The PPG or HH devices can serve as a reliable alternative for the detection of AF.
(© 2021. Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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