Boriani Giuseppe, Palmisano Pietro, Malavasi Vincenzo Livio, Fantecchi Elisa, Vitolo Marco, Bonini Niccolo', Imberti Jacopo F, Valenti Anna Chiara, Schnabel Renate B, Freedman Ben
Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, Italy.
Cardiology Unit, "Card. G. Panico" Hospital, 73039 Tricase, Italy.
J Clin Med. 2021 Feb 12;10(4):729. doi: 10.3390/jcm10040729.
Our aim was to assess the prevalence of unknown atrial fibrillation (AF) among adults during single-time point rhythm screening performed during meetings or social recreational activities organized by patient groups or volunteers. A total of 2814 subjects (median age 68 years) underwent AF screening by a handheld single-lead ECG device (MyDiagnostick). Overall, 56 subjects (2.0%) were diagnosed with AF, as a result of 12-lead ECG following a positive/suspected recording. Screening identified AF in 2.9% of the subjects ≥ 65 years. None of the 265 subjects aged below 50 years was found positive at AF screening. Risk stratification for unknown AF based on a CHADSVASc > 0 in males and >1 in females (or CHADSVA > 0) had a high sensitivity (98.2%) and a high negative predictive value (99.8%) for AF detection. A slightly lower sensitivity (96.4%) was achieved by using age ≥ 65 years as a risk stratifier. Conversely, raising the threshold at ≥75 years showed a low sensitivity. Within the subset of subjects aged ≥ 65 a CHADSVASc > 1 in males and >2 in females, or a CHADSVA > 1 had a high sensitivity (94.4%) and negative predictive value (99.3%), while age ≥ 75 was associated with a marked drop in sensitivity for AF detection.
我们的目的是评估在由患者团体或志愿者组织的会议或社交娱乐活动期间进行的单次心律筛查中,成年人中不明心房颤动(AF)的患病率。共有2814名受试者(中位年龄68岁)通过手持式单导联心电图设备(MyDiagnostick)接受了房颤筛查。总体而言,在阳性/疑似记录后进行12导联心电图检查,有56名受试者(2.0%)被诊断为房颤。筛查在≥65岁的受试者中发现房颤的比例为2.9%。在265名年龄低于50岁的受试者中,没有发现房颤筛查呈阳性者。基于男性CHADSVASc>0和女性>1(或CHADSVA>0)对不明房颤进行风险分层,对房颤检测具有高敏感性(98.2%)和高阴性预测值(99.8%)。以年龄≥65岁作为风险分层因素时,敏感性略低(96.4%)。相反,将阈值提高到≥75岁时,敏感性较低。在≥65岁的受试者亚组中,男性CHADSVASc>1且女性>2,或CHADSVA>1时,具有高敏感性(94.4%)和阴性预测值(99.3%),而年龄≥75岁与房颤检测敏感性显著下降相关。