Bristol-Myers Squibb Canada Co, Montreal, Quebec, Canada.
Department of Cardiology, Queen's University, Kingston, Ontario, Canada.
Can J Cardiol. 2019 Jul;35(7):840-845. doi: 10.1016/j.cjca.2019.03.024. Epub 2019 Apr 6.
Atrial fibrillation (AF), which affects 1% to 4% of the general population, is an important risk factor for stroke. New technologies for AF screening are now available, but their real-world application in clinical settings has not yet been thoroughly investigated. The aim of this project was to describe the introduction and feasibility of a mobile electrocardiogram (ECG) device for AF screening in a large-scale, undifferentiated population.
A total of 184 Canadian primary care physicians were provided with a KardiaMobile ECG device (AliveCor) for 3 months. Physicians were asked to obtain a single 30-second ECG recording of all patients seen in their daily practice who were ≥65 years old and not previously diagnosed with AF. Evaluation of the Kardia device by physicians was measured using a Likert scale-based questionnaire.
One hundred thirty-three physicians (72%) reported their findings and completed the survey. A total of 7585 patients were screened (42% of eligible patients). AF was detected in 471 patients (6.2%). Anticoagulation therapy was initiated in 270 patients (57%). Physicians generally reported a high perceived clinical value (94%) and ease of integration (89%) of the device.
Previously undiagnosed AF is common in older individuals attending primary care clinics. The KardiaMobile ECG device appears to be an effective screening tool for AF with high physician acceptability. More research on the feasibility of such novel technologies is warranted for future consideration of integration in population-based screening programs.
心房颤动（AF）影响 1%至 4%的普通人群，是中风的重要危险因素。目前已有用于 AF 筛查的新技术，但尚未对其在临床环境中的实际应用进行彻底研究。本项目旨在描述一种用于大规模、未分化人群的移动心电图（ECG）设备在 AF 筛查中的引入和可行性。
184 名加拿大初级保健医生配备了 KardiaMobile ECG 设备（AliveCor），使用期限为 3 个月。医生被要求对日常就诊的所有≥65 岁且未被诊断为 AF 的患者进行单次 30 秒的心电图记录。使用基于李克特量表的调查问卷来评估医生对 Kardia 设备的评估。
133 名医生（72%）报告了他们的发现并完成了调查。共筛查了 7585 名患者（42%符合条件的患者）。471 名患者（6.2%）检测到 AF。270 名患者（57%）开始接受抗凝治疗。医生普遍报告该设备具有较高的临床价值（94%）和易于整合（89%）。
在参加初级保健诊所的老年人群中，先前未诊断的 AF 很常见。KardiaMobile ECG 设备似乎是一种有效的 AF 筛查工具，医生接受程度高。需要进一步研究这些新技术的可行性，以便将来考虑将其纳入基于人群的筛查计划。
