Wiesel Joseph, Wiesel David J, Messineo Frank C
New York Hospital Queens, Flushing, New York 11355, USA.
J Stroke Cerebrovasc Dis. 2007 Jan-Feb;16(1):8-13. doi: 10.1016/j.jstrokecerebrovasdis.2006.07.004.
Detecting asymptomatic atrial fibrillation would help identify patients who would benefit from anticoagulation. This study examined the application of a modified blood pressure monitor to screen for episodes of atrial fibrillation.
A modified sphygmomanometer was designed to detect atrial fibrillation. The device has a sensitivity near 100% and a specificity of up to 91%. Therefore, this device can be expected to detect all episodes of atrial fibrillation. However, the lower specificity may result in false-positive readings that could prompt unnecessary clinic visits for electrocardiogram confirmation of the rhythm. Outpatients in sinus rhythm with a history of atrial fibrillation were given the device to monitor their pulse regularity once daily to detect atrial fibrillation. Patients with irregular readings were evaluated with an electrocardiogram.
Nineteen patients were monitored at home for a period ranging from 5 days to 5 months. Seven patients had recurrent atrial fibrillation identified by the monitor. Nine patients had no irregular readings for a mean of 82 +/- 40 days. Of 19 patients, 3 had false-positive irregular readings that were a result of sinus arrhythmia or ectopy.
The device had an acceptably low false-positive rate allowing 16 of 19 patients to use it at home for long-term atrial fibrillation monitoring. This device may help prevent strokes by identifying patients with prolonged episodes of asymptomatic atrial fibrillation who are candidates for anticoagulation.
检测无症状性心房颤动有助于识别可从抗凝治疗中获益的患者。本研究探讨了一种改良血压监测仪在筛查心房颤动发作中的应用。
设计了一种改良血压计来检测心房颤动。该设备灵敏度接近100%，特异性高达91%。因此，有望检测到所有心房颤动发作。然而，较低的特异性可能导致假阳性读数，从而促使患者因心律的心电图确认而进行不必要的门诊就诊。有房颤病史的窦性心律门诊患者被给予该设备，以便每天监测一次脉搏规律，以检测心房颤动。读数不规则的患者进行心电图评估。
19名患者在家中接受了5天至5个月的监测。7名患者通过监测发现有复发性心房颤动。9名患者平均82±40天无读数不规则情况。19名患者中，3名因窦性心律失常或异位心律出现假阳性不规则读数。
该设备的假阳性率较低，可接受，19名患者中有16名能够在家中使用它进行长期心房颤动监测。该设备可通过识别有长时间无症状性心房颤动发作且适合抗凝治疗的患者，有助于预防中风。
