Omboni Stefano, Verberk Willem J
Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy.
Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands Microlife AG, Widnau, Switzerland.
BMJ Open. 2016 Apr 12;6(4):e010745. doi: 10.1136/bmjopen-2015-010745.
Timely detection of atrial fibrillation (AF) may effectively prevent cardiovascular consequences. However, traditional diagnostic tools are either poorly reliable (pulse palpation) or not readily accessible (ECG) in general practice. We tested whether an automatic oscillometric blood pressure (BP) monitor embedded with an algorithm for AF detection might be effective for opportunistic screening of asymptomatic AF in the community.
A community-based screening campaign in an unselected population to verify the feasibility of AF screening with a Microlife WatchBP Office BP monitor with a patented AFIB algorithm. When possible AF was detected (≥2 of 3 BP measurements reporting AF), a doctor immediately performed a single-lead ECG in order to confirm or exclude the presence of the arrhythmia. The main demographic and clinical data were also collected.
220 consecutive participants from an unselected sample of individuals in a small Italian community.
Number of patients detected with AF and diagnosed risk factors for AF.
In 12 of 220 participants, the device detected possible AF during the BP measurement: in 4 of them (1.8%), the arrhythmia was confirmed by the ECG. Patients with AF were more likely to be older (77.0±1.2 vs 57.2±15.2 years, p=0.010), obese (50.0 vs 14.4%, p=0.048) and to suffer from a cardiovascular disease (50.0 vs 10.6%, p=0.014) than patients without AF. Participants with a positive BP AF reading and non-AF arrhythmias (n=8) did not differ in their general characteristics from participants with a negative BP AF reading and were younger than patients with AF (mean age 56.4±14.8, p=0.027; 5 of 8 participants aged <65 years).
Opportunistic screening of AF by BP measurement is feasible to diagnose this arrhythmia in unaware participants, particularly in those older than 65 years, who are the target patient group recommended by current AF screening guidelines.
及时检测房颤（AF）可有效预防心血管疾病后果。然而，在一般医疗实践中，传统诊断工具要么可靠性差（脉搏触诊），要么不易获得（心电图）。我们测试了一种嵌入房颤检测算法的自动示波血压（BP）监测仪是否可有效用于社区无症状房颤的机会性筛查。
在未经过筛选的人群中开展基于社区的筛查活动，以验证使用带有专利房颤算法的Microlife WatchBP Office血压监测仪进行房颤筛查的可行性。当检测到可能的房颤时（3次血压测量中有≥2次报告为房颤），医生立即进行单导联心电图检查以确认或排除心律失常的存在。同时收集主要的人口统计学和临床数据。
来自意大利一个小社区未经过筛选的连续220名个体。
检测出房颤的患者数量以及诊断出的房颤危险因素。
在220名参与者中，有12人在血压测量期间该设备检测到可能的房颤：其中4人（1.8%）经心电图确认有心律失常。与无房颤患者相比，房颤患者年龄更大（77.0±1.2岁 vs 57.2±15.2岁，p = 0.010）、更肥胖（50.0% vs 14.4%，p = 0.048）且患有心血管疾病的比例更高（50.0% vs 10.6%，p = 0.014）。血压房颤读数为阳性且伴有非房颤心律失常的参与者（n = 8）在一般特征上与血压房颤读数为阴性的参与者无差异，且比房颤患者更年轻（平均年龄56.4±14.8岁，p = 0.027；8名参与者中有5名年龄<65岁）。
通过血压测量对房颤进行机会性筛查对于在未意识到的参与者中诊断这种心律失常是可行的，特别是在65岁以上人群中，他们是当前房颤筛查指南推荐的目标患者群体。
