Tu Hans T, Chen Ziyuan, Swift Corey, Churilov Leonid, Guo Ruibing, Liu Xinfeng, Jannes Jim, Mok Vincent, Freedman Ben, Davis Stephen M, Yan Bernard
1 Melbourne Brain Centre, Royal Melbourne Hospital, the University of Melbourne, Victoria, Australia.
2 Department of Neurology, Royal Melbourne Hospital, the University of Melbourne, Victoria, Australia.
Int J Stroke. 2017 Oct;12(7):786-789. doi: 10.1177/1747493017696097. Epub 2017 Mar 8.
Rationale Paroxysmal atrial fibrillation is a common and preventable cause of devastating strokes. However, currently available monitoring methods, including Holter monitoring, cardiac telemetry and event loop recorders, have drawbacks that restrict their application in the general stroke population. AliveCor™ heart monitor, a novel device that embeds miniaturized electrocardiography (ECG) in a smartphone case coupled with an application to record and diagnose the ECG, has recently been shown to provide an accurate and sensitive single lead ECG diagnosis of atrial fibrillation. This device could be used by nurses to record a 30-s ECG instead of manual pulse taking and automatically provide a diagnosis of atrial fibrillation. Aims To compare the proportion of patients with paroxysmal atrial fibrillation detected by AliveCor™ ECG monitoring with current standard practice. Sample size 296 Patients. Design Consecutive ischemic stroke and transient ischemic attack patients presenting to participating stroke units without known atrial fibrillation will undergo intermittent AliveCor™ ECG monitoring administered by nursing staff at the same frequency as the vital observations of pulse and blood pressure until discharge, in addition to the standard testing paradigm of each participating stroke unit to detect paroxysmal atrial fibrillation. Study outcome Proportion of patients with paroxysmal atrial fibrillation detected by AliveCor™ ECG monitoring compared to 12-lead ECG, 24-h Holter monitoring and cardiac telemetry. Discussion Use of AliveCor™ heart monitor as part of routine stroke unit nursing observation has the potential to be an inexpensive non-invasive method to increase paroxysmal atrial fibrillation detection, leading to improvement in stroke secondary prevention.
阵发性心房颤动是导致严重中风的常见且可预防的原因。然而，目前可用的监测方法，包括动态心电图监测、心脏遥测和事件循环记录仪，都存在一些缺点，限制了它们在一般中风人群中的应用。AliveCor™心脏监测仪是一种新型设备，它将小型化心电图（ECG）嵌入智能手机壳中，并配有记录和诊断心电图的应用程序，最近已被证明能提供准确且灵敏的单导联心电图房颤诊断。该设备可供护士用于记录30秒心电图，而非手动测量脉搏，并能自动提供房颤诊断。目的：比较通过AliveCor™心电图监测检测到的阵发性心房颤动患者比例与当前标准做法。样本量：296例患者。设计：连续入住参与研究的卒中单元且无已知心房颤动的缺血性卒中和短暂性脑缺血发作患者，除了每个参与卒中单元用于检测阵发性心房颤动的标准测试范式外，还将接受由护理人员按照与脉搏和血压生命体征观察相同的频率进行的间歇性AliveCor™心电图监测，直至出院。研究结果：将通过AliveCor™心电图监测检测到的阵发性心房颤动患者比例与12导联心电图、24小时动态心电图监测和心脏遥测进行比较。讨论：将AliveCor™心脏监测仪用作卒中单元常规护理观察的一部分，有可能成为一种廉价的非侵入性方法，以增加阵发性心房颤动的检测率，从而改善中风的二级预防。
