Department of Internal Medicine I, Chemnitz Clinic gGmbH, 09113 Chemnitz, Germany.
J Telemed Telecare. 2009;15(8):391-6. doi: 10.1258/jtt.2009.090402.
In order to test a newly developed algorithm for detecting atrial fibrillation in clinical practice, we carried out parallel recordings using a conventional 24-h electrocardiogram (ECG) monitor and telemonitoring with an external loop recorder. Recordings were made in 24 patients with persistent atrial fibrillation and in another 24 patients with sinus rhythm. Atrial fibrillation was detected immediately in 23 of 24 patients with persistent atrial fibrillation and 20 min after fitting the single-channel loop recorder in the 24th patient (sensitivity 100%). On average, 3.1 false positives (i.e. detection of an episode, including the end or beginning of atrial fibrillation) were transmitted per patient. The sensitivity of the algorithms for automatically detecting bradycardiac and tachycardiac atrial fibrillation was also high. In 12 of 24 patients with sinus rhythm, false-positive tele-ECGs were transmitted. These were caused by supraventricular or ventricular extrasystoles and by sinus arrhythmias or sinoatrial (SA) blocks. The external loop recorder was very effective at detecting paroxysmal atrial fibrillation. Possible indications for the clinical use of this recorder include, in addition to diagnosis, monitoring patients for atrial fibrillation recurrence after cardioversion or catheter ablation.
为了在临床实践中测试一种新开发的用于检测心房颤动的算法，我们使用常规的 24 小时心电图（ECG）监测仪和带有外部环路记录器的远程监测进行了平行记录。在 24 例持续性心房颤动患者和 24 例窦性节律患者中进行了记录。在 24 例持续性心房颤动患者中，立即在 23 例患者中检测到心房颤动，在第 24 例患者中安装单通道环路记录器 20 分钟后检测到（敏感性 100%）。平均每个患者传输 3.1 次假阳性（即检测到包括心房颤动结束或开始的发作）。自动检测缓慢性和快速性心房颤动的算法的灵敏度也很高。在 24 例窦性节律患者中有 12 例传输了假阳性远程 ECG。这些是由室上性或室性期前收缩以及窦性心律失常或窦性（SA）阻滞引起的。外部环路记录器非常有效地检测阵发性心房颤动。这种记录器的临床应用的可能指征包括，除了诊断之外，还包括在电复律或导管消融后监测心房颤动复发的患者。
