Atrial fibrillation detection with a portable device during cardiovascular screening in primary care
| Autor: | Luisa Campos Caldeira Brant, Andrea Beaton, Augusto F.C. Pereira, Laura Olivieri, Marcia M. Barbosa, Alison Tompsett, Lara C Rabelo, Kaciane K.B. Oliveira, Mariana D.O. Mata, Adriana C. Diamantino, Waydder Antônio A. Costa, Craig Sable, Luciana C Diamantino, Antonio Luiz Pinho Ribeiro, Maria do Carmo Pereira Nunes, Bruno Ramos Nascimento |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Heart disease Action Potentials Primary care 030204 cardiovascular system & hematology Electrocardiography 03 medical and health sciences 0302 clinical medicine Heart Conduction System Heart Rate Predictive Value of Tests Internal medicine Atrial Fibrillation Epidemiology Prevalence Humans Medicine Sampling (medicine) 030212 general & internal medicine Risk factor Aged Primary Health Care business.industry Reproducibility of Results Mean age Atrial fibrillation Equipment Design Middle Aged Prognosis medicine.disease Telemedicine Echocardiography Cardiology Feasibility Studies Female Cardiology and Cardiovascular Medicine business Intermediate risk Brazil |
| Zdroj: | Heart. 106:1261-1266 |
| ISSN: | 1468-201X 1355-6037 |
| Popis: | IntroductionA novel handheld dual-electrode stick is a portable atrial fibrillation (AF) screening device (AFSD). We evaluated AFSD performance in primary care patients referred for echocardiogram (echo).MethodsThe AFSD has a light indication of irregular rhythm and single-lead ECG recording. Patients were instructed to hold the device for 1 min, and AF indication was recorded. A 12-lead ECG was performed for all AFSD-positive patients and 250 patients with negative AFSD screen. Echos were performed based on a clinical risk score: all high-risk patients and a sampling of low-risk patients underwent complete echo. Intermediate risk patients first had a screening echocardiogram, with a follow-up complete study if abnormality was suspected.ResultsIn 5 days, 1518 patients underwent clinical evaluation and cardiovascular risk stratification: mean age 58±16 years, 66% women. The AFSD was positive in 6.4%: 12.6% high risk, 6.1% intermediate risk and 2.2% low risk. Older age was a risk factor (9.3% vs 4.8% in those more than and less than 65 years, p=0.001). AFSD positive was independently associated with heart disease in echo (OR=3.9, 95% CI 2.1 to 7.2, pConclusionAFSD demonstrated high sensitivity for AF detection in primary care patients referred for echo. AF prevalence was substantial and independently associated with structural or functional heart disease, suggesting that AFSD screening could be a useful primary care tool to stratify risk and prioritise echo. |
| Databáze: | OpenAIRE |
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