胸带心电图检测心房颤动的效果。

Effectiveness of the Chest Strap Electrocardiogram to Detect Atrial Fibrillation.

机构信息

Center for Prehospital Emergency Care, Kuopio University Hospital, Kuopio, Finland.

University of Eastern Finland, Department of Applied Physics, Kuopio, Finland.

出版信息

Am J Cardiol. 2019 May 15;123(10):1643-1648. doi: 10.1016/j.amjcard.2019.02.028. Epub 2019 Feb 23.

DOI:10.1016/j.amjcard.2019.02.028

PMID:30878151

Abstract

Atrial fibrillation (AF) is a significant cause of cardioembolic strokes. AF is often symptomless and intermittent, making its detection challenging. The aim of this study was to assess the possibility to use a chest strap (Suunto Movesense) to detect AF both by cardiologists and automated algorithms. A single channel electrocardiogram (ECG) from a chest strap of 220 patients (107 AF and 111 sinus rhythm SR with 2 inconclusive rhythms) were analyzed by 2 cardiologists (Doc1 and Doc2) and 2 different algorithms (COSEn and AFEvidence). A 3-lead Holter served as the gold standard ECG for rhythm analysis. Both cardiologists evaluated the quality of the chest strap ECG to be superior to the quality of the Holter ECG; p <0.05/p <0.001 (Doc1/Doc 2). Accurate automated algorithm-based AF detection was achieved with sensitivity of 95.3%/96.3% and specificity of 95.5/98.2% with 2 AF detection algorithms from chest strap and 93.5%/97.2% and 98.2%/95.5% from Holter, respectively. P waves were detectable in 93.7% (Doc1) and 94.6% (Doc2) of the cases from the chest strap ECG with sinus rhythm and 98.2% (Doc1) and 95.5% (Doc2) from the Holter (p = n.s). In conclusion, the ECGs from both methods enabled AF detection by a cardiologist and by automated algorithms. Both methods studied enabled P-wave detection in sinus rhythm.

摘要

心房颤动（AF）是心源性脑栓塞的重要原因。AF 常无症状且间歇性发作，因此其检测具有挑战性。本研究旨在评估使用胸带（Suunto Movesense）由心脏病专家和自动化算法检测 AF 的可能性。对 220 名患者（107 例 AF 和 111 例窦性心律 SR，其中 2 例节律不确定）的胸带单通道心电图（ECG）进行了分析，由 2 位心脏病专家（Doc1 和 Doc2）和 2 种不同的算法（COSEn 和 AF Evidence）进行分析。3 导联动态心电图作为节律分析的金标准 ECG。两位心脏病专家均评估了胸带 ECG 的质量优于动态心电图的质量；p<0.05/p<0.001（Doc1/Doc 2）。两种基于自动算法的 AF 检测算法均能实现 95.3%/96.3%的敏感性和 95.5%/98.2%的特异性，两种 AF 检测算法的特异性分别为 93.5%/97.2%和 98.2%/95.5%，分别来自胸带和动态心电图。窦性心律时，胸带 ECG 中 93.7%（Doc1）和 94.6%（Doc2）的 P 波可检测到，动态心电图中 98.2%（Doc1）和 95.5%（Doc2）的 P 波可检测到（p=n.s）。总之，两种方法的心电图都能使心脏病专家和自动化算法进行 AF 检测。两种方法都能检测到窦性心律中的 P 波。