Kristensen Anne N, Jeyam Brintha, Riahi Sam, Jensen Martin B
Research Unit for General Practice in Aalborg, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Atrial Fibrillation Study Group, Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
Scand J Prim Health Care. 2016 Sep;34(3):304-308. doi: 10.1080/02813432.2016.1207151. Epub 2016 Jul 13.
To evaluate how well an inexpensive portable three-lead ECG monitor PEM identified patients with atrial fibrillation (AF) compared to a normal 12-lead ECG. Cross-sectional method comparison study. From April 2014 to February 2015, we included patients coming to the general practice clinic "Lægerne Sløjfen", Aalborg, Denmark for a routine ECG. Patients with severe dementia, mental illness or poor ECG readings were excluded. After oral and written informed consent an ECG and PEM recordings were obtained simultaneously. The PEM recordings were analyzed by two general practitioners (GPs) in training and ECG recordings were evaluated by a senior GP and a cardiologist. Both the PEM and the ECG recordings were analysed blinded. Ninety-three patients were included and four were excluded due to poor ECG readings. The sensitivity and specificity of PEM compared to a standard 12-lead ECG. Eighty-nine of the 93 (95.7%) patients had ECGs of a satisfactory technical quality and were included in the study. The sensitivity of diagnosing AF by PEM recordings was 86.7% and the specificity was 98.7% when compared to a 12-lead ECG. According to the cardiologist, the misclassification of three PEM recordings were due to interpretation errors and not related to the PEM recording . The inexpensive portable PEM device recording diagnosed AF with a high sensitivity and specificity.KEY POINTSSimple ECG monitors could be useful to identify atrial fibrillation and thereby lead to a better prevention of stroke.The PEM device was easy to use and 95.7% of the recordings were technically acceptable for detecting atrial fibrillation.The PEM device has a high sensitivity and specificity in detecting atrial fibrillation compared to a standard 12-lead ECG.Further studies should evaluate the clinical usefulness of the PEM device, e.g. to detect intermittent atrial fibrillation.
为评估一款价格低廉的便携式三导联心电图监测仪（PEM）与常规12导联心电图相比，在识别房颤（AF）患者方面的效果。横断面方法比较研究。2014年4月至2015年2月，我们纳入了前往丹麦奥尔堡“Lægerne Sløjfen”全科诊所进行常规心电图检查的患者。排除患有严重痴呆、精神疾病或心电图读数不佳的患者。在获得口头和书面知情同意后，同时获取心电图和PEM记录。由两名接受培训的全科医生（GP）分析PEM记录，由一名资深GP和一名心脏病专家评估心电图记录。PEM和心电图记录均采用盲法分析。共纳入93例患者，4例因心电图读数不佳被排除。比较PEM与标准12导联心电图的敏感性和特异性。93例患者中有89例（95.7%）的心电图技术质量令人满意并纳入研究。与12导联心电图相比，通过PEM记录诊断房颤的敏感性为86.7%，特异性为98.7%。据心脏病专家称，3份PEM记录的错误分类是由于解读错误，而非与PEM记录有关。这款价格低廉的便携式PEM设备记录诊断房颤具有较高的敏感性和特异性。要点简单的心电图监测仪可能有助于识别房颤，从而更好地预防中风。PEM设备易于使用，95.7%的记录在技术上可用于检测房颤。与标准12导联心电图相比，PEM设备在检测房颤方面具有较高的敏感性和特异性。进一步的研究应评估PEM设备的临床实用性，例如检测间歇性房颤。
