Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Emergency Pediatrics Clinic, AIC Kijabe Hospital, Kijabe, Kenya.
Glob Heart. 2017 Dec;12(4):285-289. doi: 10.1016/j.gheart.2016.12.003. Epub 2017 Mar 13.
Screening for atrial fibrillation (AF), a major risk factor for stroke that is on the rise in Africa, is becoming increasingly critical.
This study sought to examine the feasibility of using mobile electrocardiogram (ECG) recording technology to detect AF.
In this prospective observational study, we used a mobile ECG recorder to screen 50 African adults (66% women; mean age 54.3 ± 20.5 years) attending Kijabe Hospital (Kijabe, Kenya). Five hospital health providers involved in this study's data collection process also completed a self-administered survey to obtain information on their access to the Internet and mobile devices, both factors necessary to implement ECG mobile technology. Outcome measures included feasibility (completion of the study and recruitment of the patients on the planned study time frame) and the yield of the screening by the mobile ECG technology (ability to detect previously undiagnosed AF).
Patients were recruited in a 2-week period as planned; only 1 of the 51 patients approached refused to participate (98% acceptance rate). All of the 50 patients who agreed to participate completed the test and produced readable ECGs (100% study completion rate). ECG tracings of 4 of the 50 patients who completed the study showed AF (8% AF yield), and none had been previously diagnosed with AF. When asked about continuous access to Internet and personal mobile devices, almost all of the health care providers surveyed answered affirmatively.
Using mobile ECG technology in screening for AF in low-resource settings is feasible, and can detect a significant proportion of AF cases that will otherwise go undiagnosed. Further study is needed to examine the cost-effectiveness of this approach for detection of AF and its effect on reducing the risk of stroke in developing countries.
心房颤动（AF）是一种主要的风险因素，可导致中风，在非洲呈上升趋势，因此对其进行筛查变得越来越重要。
本研究旨在探讨使用移动心电图（ECG）记录技术检测 AF 的可行性。
在这项前瞻性观察性研究中，我们使用移动 ECG 记录器对 50 名在肯尼亚基杰贝医院就诊的非洲成年人（66%为女性；平均年龄 54.3±20.5 岁）进行了筛查。参与本研究数据收集过程的 5 名医院卫生保健提供者还完成了一份自我管理调查，以获取有关他们访问互联网和移动设备的信息，这两个因素都是实施 ECG 移动技术所必需的。主要结局指标包括可行性（按计划的研究时间框架完成研究并招募患者）和移动 ECG 技术筛查的结果（检测到先前未诊断的 AF 的能力）。
按计划在 2 周内招募了患者；仅在 51 名接近的患者中有 1 名拒绝参与（接受率为 98%）。所有同意参与的 50 名患者均完成了测试并产生了可读的心电图（完成研究的比例为 100%）。完成研究的 50 名患者中有 4 名心电图显示 AF（AF 检出率为 8%），且均未被先前诊断为 AF。当被问及是否可以持续访问互联网和个人移动设备时，接受调查的几乎所有卫生保健提供者都给予了肯定的回答。
在资源匮乏的环境中使用移动 ECG 技术筛查 AF 是可行的，并且可以检测到相当一部分否则未被诊断的 AF 病例。需要进一步研究来检验这种方法检测 AF 的成本效益及其对减少发展中国家中风风险的影响。
