Sanmartín Marcelo, Fraguela Fraga Francisco, Martín-Santos Angel, Moix Blázquez Pilar, García-Ruiz Alba, Vázquez-Caamaño María, Vilar Manuel
Servicio de Cardiología, Hospital Povisa, Vigo, Pontevedra, España.
Rev Esp Cardiol (Engl Ed). 2013 Jan;66(1):34-8. doi: 10.1016/j.recesp.2012.05.012. Epub 2012 Sep 8.
Atrial fibrillation occurs in 5%-15% of elderly patients and causes one-fourth to one-fifth of all cerebrovascular events. These patients are frequently asymptomatic. We conducted a public campaign aiming to evaluate the effectiveness of a program for information on and diagnosis of atrial fibrillation in individuals aged 65 years old or more from the primary care perspective.
We sent letters containing informative materials and an invitation to attend a special nurse appointment to all individuals≥65 years old, without a previous diagnosis of atrial fibrillation or flutter. Patients were from 3 specific areas in Pontevedra province. The procedures were performed according to a specially designed program called "Pulse Week" within 5 working days. A group of trained nurses obtained a brief medical history and performed pulse palpation for 15 s and blood pressure measurement. A complete 12-lead electrocardiogram was performed if arrhythmic pulsations were detected.
A total of 8869 letters were sent. During the specified week, 1532 individuals were evaluated (877 women); the mean age was 72.5 (6.5) years old, 833 had hypertension (54%), 232 had diabetes (15%), 61 had previous stroke (4%) and 88 had had a myocardial infarction (6%). Electrocardiograms were performed in 187 patients. There were 17 patients with newly diagnosed atrial fibrillation.
A public, 5-day campaign based on pulse palpation and targeting elderly individuals had little impact on the detection of new cases of atrial fibrillation in our environment.
心房颤动发生于5% - 15%的老年患者中，且导致了四分之一至五分之一的所有脑血管事件。这些患者常常没有症状。我们开展了一项公共活动，旨在从初级保健的角度评估一项针对65岁及以上人群的心房颤动信息与诊断项目的有效性。
我们向所有年龄≥65岁、既往未诊断为心房颤动或心房扑动的个体发送了包含信息材料的信件以及参加特别护士预约的邀请。患者来自蓬特韦德拉省的3个特定区域。这些程序在5个工作日内按照一个名为“脉搏周”的专门设计的项目进行。一组经过培训的护士获取简要病史，并进行15秒的脉搏触诊和血压测量。如果检测到心律失常搏动，则进行完整的12导联心电图检查。
共发送了886份信件。在指定的那一周，对1532名个体进行了评估（877名女性）；平均年龄为72.5（6.5）岁，833人患有高血压（54%），232人患有糖尿病（15%），61人既往有中风史（4%），88人曾发生心肌梗死（6%）。对187名患者进行了心电图检查。有17名患者新诊断为心房颤动。
在我们的环境中，一项为期5天、基于脉搏触诊且针对老年人的公共活动对新发心房颤动病例的检测影响甚微。
