Somerville S, Somerville J, Croft P, Lewis M
Primary Care Sciences Research Centre, Keele University School of Postgraduate Medicine, Stoke-on-Trent.
Br J Gen Pract. 2000 Sep;50(458):727-9.
The importance of atrial fibrillation as a treatable risk factor for stroke is well established. Less is known about how to find previously unidentified cases within the community so that antithrombotic treatment can be offered to a wider group of at-risk patients. The aim of our study was to examine ways to improve the efficiency of practice-based screening for atrial fibrillation, including issues of time and financial cost. We used different combinations of pulse palpation and interpretation of 12-lead and bipolar electrocardiographs as carried out by practice nurses. The best strategy for the detection of atrial fibrillation in a practice population would appear to be to screen all eligible subjects by nurse pulse palpation, followed by 12-lead electrocardiograph readings in those who have a pulse suggestive of atrial fibrillation. The electrocardiograph interpretation can be undertaken effectively by a trained nurse.
心房颤动作为一种可治疗的中风危险因素的重要性已得到充分证实。对于如何在社区中发现以前未被识别的病例，以便能为更广泛的高危患者群体提供抗血栓治疗，人们了解得较少。我们研究的目的是探讨提高基于实践的心房颤动筛查效率的方法，包括时间和财务成本问题。我们采用了由执业护士进行的脉搏触诊以及对12导联和双极心电图的解读的不同组合方式。在实践人群中检测心房颤动的最佳策略似乎是通过护士脉搏触诊对所有符合条件的受试者进行筛查，然后对那些脉搏提示心房颤动的受试者进行12导联心电图检查。心电图解读可由经过培训的护士有效完成。
