Vaes Bert, Stalpaert Silke, Tavernier Karen, Thaels Britt, Lapeire Daphne, Mullens Wilfried, Degryse Jan
Department of General Practice, Katholieke Universiteit Leuven (KUL), Leuven, Belgium.
BMC Fam Pract. 2014 Jun 9;15:113. doi: 10.1186/1471-2296-15-113.
Atrial fibrillation is very common in people aged 65 or older. This condition increases the risk of death, congestive heart failure and thromboembolic conditions. Many patients with atrial fibrillation are asymptomatic and a cerebrovascular accident (CVA) is often the first clinical presentation. Guidelines concerning the prevention of CVA recommend monitoring the heart rate in patients aged 65 or older. Recently, the MyDiagnostick (Applied Biomedical Systems BV, Maastricht, The Netherlands) was introduced as a new screening tool which might serve as an alternative for the less accurate pulse palpation. This study was designed to explore the diagnostic accuracy of the MyDiagnostick for the detection of atrial fibrillation.
A phase II diagnostic accuracy study in a convenience sample of 191 subjects recruited in primary care. The majority of participants were patients with a known history of atrial fibrillation (n=161). Readings of the MyDiagnostick were compared with electrocardiographic recordings. Sensitivity and specificity and their 95% confidence interval were calculated using 2x2 tables.
A prevalence of 54% for an atrial fibrillation rhythm was found in the study population at the moment of the study. A combination of three measurements with the MyDiagnostick for each patient showed a sensitivity of 94% (95% CI 87 - 98) and a specificity of 93% (95% CI 85 - 97).
The MyDiagnostick is an easy-to-use device that showed a good diagnostic accuracy with a high sensitivity and specificity for atrial fibrillation in a convenience sample in primary care. Future research is needed to determine the place of the MyDiagnostick in possible screening or case-finding strategies for atrial fibrillation.
房颤在65岁及以上人群中非常常见。这种情况会增加死亡、充血性心力衰竭和血栓栓塞性疾病的风险。许多房颤患者没有症状，而脑血管意外（CVA）往往是其首次临床表现。关于预防CVA的指南建议对65岁及以上患者的心率进行监测。最近，MyDiagnostick（应用生物医学系统公司，荷兰马斯特里赫特）作为一种新的筛查工具被引入，它可能是不太准确的脉搏触诊的替代方法。本研究旨在探讨MyDiagnostick检测房颤的诊断准确性。
在初级保健机构招募的191名受试者的便利样本中进行了一项II期诊断准确性研究。大多数参与者是有房颤病史的患者（n = 161）。将MyDiagnostick的读数与心电图记录进行比较。使用2×2表格计算敏感性、特异性及其95%置信区间。
在研究时，研究人群中房颤心律的患病率为54%。对每位患者使用MyDiagnostick进行三次测量的组合显示敏感性为94%（95%CI 87 - 98）和特异性为9
