Kaasenbrood Femke, Hollander Monika, Rutten Frans H, Gerhards Leo J, Hoes Arno W, Tieleman Robert G
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Strat 6.131, PO Box 85500, Utrecht 3508 GA, The Netherlands
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Strat 6.131, PO Box 85500, Utrecht 3508 GA, The Netherlands.
Europace. 2016 Oct;18(10):1514-1520. doi: 10.1093/europace/euv426. Epub 2016 Feb 6.
To assess the yield of screening for atrial fibrillation (AF) with a hand-held single-lead electrocardiogram (ECG) device during influenza vaccination in primary care in the Netherlands.
We used the MyDiagnostick to screen for AF in persons who participated in influenza vaccination sessions of ten Dutch primary care practices. In case of suspected AF detection by the stick, the recorded 1-min ECG registrations were analysed by a cardiologist. We scrutinized electronic medical files of the general practitioners to obtain information about the cases screened. Multivariable logistic regression analysis was performed to predict the relation between patient characteristics and a new screen-detected diagnosis of AF. In total, 3269 persons were screened for AF during the influenza vaccination sessions of 10 general practitioner practices. As a result, 37 (1.1%) new cases of AF were detected. Prior transient ischeamic attack or stroke (OR 6.05; 95%CI 1.93-19.0), and age (OR 1.09 per year; 95% CI 1.05-1.14) were independent predictors for such newly screen-detected AF. Of the 37 screen-detected AF cases, 2.7% had a CHADS-VASc of 0, 18.9% a score of 1, and 78.4% a score of 2 or more. The majority needed oral anticoagulant therapy.
Screening seems feasible with an easy to use single-lead, hand-held ECG device with automatic AF detection during influenza vaccination in primary care and results in a '1-day' yield of 1.1% new cases of AF.
NCT02006524.
评估在荷兰初级医疗保健机构进行流感疫苗接种期间，使用手持式单导联心电图（ECG）设备筛查房颤（AF）的检出率。
我们使用MyDiagnostick对参与荷兰十家初级医疗保健机构流感疫苗接种的人员进行房颤筛查。如果该设备检测到疑似房颤，由心脏病专家分析记录的1分钟心电图。我们仔细查阅全科医生的电子病历以获取筛查病例的信息。进行多变量逻辑回归分析以预测患者特征与新筛查出的房颤诊断之间的关系。在10家全科医生诊所的流感疫苗接种期间，总共对3269人进行了房颤筛查。结果，检测到37例（1.1%）新发房颤病例。既往短暂性脑缺血发作或中风（比值比[OR]6.05；95%置信区间[CI]1.93 - 19.0）以及年龄（每年OR 1.09；95%CI 1.05 - 1.14）是新筛查出的此类房颤的独立预测因素。在37例筛查出的房颤病例中，2.7%的CHADS - VASc评分为0，18.9%评分为1，78.4%评分为2或更高。大多数患者需要口服抗凝治疗。
在初级医疗保健机构进行流感疫苗接种期间，使用易于操作的单导联手持式自动检测房颤的心电图设备进行筛查似乎可行，房颤新病例的“单日”检出率为1.1%。
ClinicalTrials.gov：NCT02006524。
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