通过手持设备对老年人进行不明原因心房颤动的筛查。
Screening of unknown atrial fibrillation through handheld device in the elderly.
作者信息
Rivezzi Francesco, Vio Riccardo, Bilato Claudio, Pagliani Leopoldo, Pasquetto Giampaolo, Saccà Salvatore, Verlato Roberto, Migliore Federico, Iliceto Sabino, Bossone Vito, Bertaglia Emanuele
机构信息
Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Division of Cardiology, West Vicenza General Hospitals, Arzignano, Vicenza, Italy.
出版信息
J Geriatr Cardiol. 2020 Aug;17(8):495-501. doi: 10.11909/j.issn.1671-5411.2020.08.008.
OBJECTIVE
To estimate the prevalence of unknown atrial fibrillation (AF) in the elderly population of the Veneto Region, Italy.
METHODS
1820 patients aged ≥ 65 years with no history of AF and not anticoagulated were enrolled in primary-care settings. They underwent an opportunistic electrocardiogram screening with a handheld device (MyDiagnostick) designed to specifically detect AF. The electrocardiogram recordings were reviewed by the researchers, who confirmed the presence of AF.
RESULTS
The device detected an arrhythmia in 143 patients, which was confirmed as AF in 101/143 (70.6%), with an overall prevalence of AF of 5.5% (101/1820). Prevalence of unknown AF resulted in 3.6% in patients aged 65-74 years, and 7.5% in patients age 75 or older, and increased according to CHADS-VASc score: 3.5% in patients with a score of 1 or 2, 5.6% in patients with a score of 3, 7.0% in patients with a score of 4, and 7.2% in patients with a score ≥ 5. The detection rate was significantly higher in patients with mild symptoms compared to asymptomatic counterparts (24.1% 4.0%, < 0.0001). At multivariate analysis, congestive heart failure and age ≥ 75 years-old were independent predictors for screen-detected AF.
CONCLUSIONS
An opportunistic screening with handheld device revealed an unexpectedly high prevalence of unknown AF in elderly patients with mild symptoms. Prevalence increased with age and CHADS-VASc score.
目的
评估意大利威尼托地区老年人群中不明原因房颤（AF）的患病率。
方法
1820名年龄≥65岁、无房颤病史且未接受抗凝治疗的患者纳入基层医疗机构研究。他们使用一款专门用于检测房颤的手持设备（MyDiagnostick）进行机会性心电图筛查。研究人员对心电图记录进行复查，以确认房颤的存在。
结果
该设备检测到143例心律失常，其中101/143（70.6%）被确认为房颤，房颤总体患病率为5.5%（101/1820）。65 - 74岁患者不明原因房颤患病率为3.6%，75岁及以上患者为7.5%，且根据CHADS - VASc评分增加：评分为1或2的患者中患病率为3.5%，评分为3的患者中为5.6%，评分为4的患者中为7.0%，评分≥5的患者中为7.2%。有轻微症状的患者检测率显著高于无症状患者（24.1%对4.0%，P<0.0001）。多因素分析显示，充血性心力衰竭和年龄≥75岁是筛查发现房颤的独立预测因素。
结论
使用手持设备进行机会性筛查发现，有轻微症状的老年患者中不明原因房颤患病率出乎意料地高。患病率随年龄和CHADS - VASc评分增加。
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