Harskamp Ralf E
Department of General Practice, Amsterdam University Medical Centers - Location Academic Medical Center, Amsterdam, The Netherlands.
Prim Health Care Res Dev. 2019 Jun 25;20:e101. doi: 10.1017/S1463423619000355.
Electrocardiograms (ECGs) are frequently recorded in primary care for screening purposes. An ECG is essential in diagnosing atrial fibrillation, and ECG abnormalities are associated with cardiovascular events. While recent studies show that ECGs adequately reclassify a proportion of patients based on the clinical risk score calculations, there are no data to support that this also results in improved health outcomes. When applied for screening for atrial fibrillation, more cases are found with routine care, but this would be undone when physicians would perform systematic pulse palpation. In most studies, the harms of routine ECG use (such as unnecessary diagnostic testing, emotional distress, increased health expenses) were poorly documented. As such, the routine performing of ECGs in asymptomatic primary care patients, whether it is for cardiovascular disease risk assessment or atrial fibrillation, cannot be recommended.
心电图（ECG）在基层医疗中经常用于筛查目的。心电图对于诊断心房颤动至关重要，且心电图异常与心血管事件相关。虽然近期研究表明，基于临床风险评分计算，心电图能对一部分患者进行充分的重新分类，但尚无数据支持这也能改善健康结局。当用于筛查心房颤动时，常规护理能发现更多病例，但如果医生进行系统的脉搏触诊，这种情况就会改变。在大多数研究中，常规使用心电图的危害（如不必要的诊断检查、情绪困扰、医疗费用增加）记录不足。因此，不建议在无症状的基层医疗患者中常规进行心电图检查，无论其目的是心血管疾病风险评估还是心房颤动筛查。
